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Medical management of metabolic and cardiovascular complications after liver transplantation

World Journal of Gastroenterology 2020年第18期26卷 2138-2154页

作者： chiara becchetti Melisa Dirchwolf Vanessa Banz Jean-Francois Dufour Hepatology Department of Visceral Surgery and MedicineInselspitalUniversity Hospital BernBern CH-3008Switzerland Department of Biomedical Research University of BernBern CH-3008Switzerland Hepatology Hepatobiliary Surgery and Liver Transplant UnitHospital Privado de RosarioRosario S2000GAPSanta FeArgentina Department of Visceral Surgery and Medicine InselspitalUniversity Hospital BernBern CH-3008Switzerland Department of Clinical Research University of BernBern CH-3008Switzerland

Liver transplantation represents the only curative option for patients with endstage liver disease,fulminant hepatitis and advanced hepatocellular *** though major advances in transplantation in the last decades have achieved excellent survival rates in the early post-transplantation period,long-term survival is hampered by the lack of improvement in survival in the late post transplantation period(over 5 years after transplantation).The main etiologies for late mortality are malignancies and cardiovascular *** latter are increasingly prevalent in liver transplant recipients due to the development or worsening of metabolic syndrome and all its components(arterial hypertension,dyslipidemia,obesity,renal injury,etc.).These comorbidities result from a combination of pre-liver transplant features,immunosuppressive agent side-effects,changes in metabolism and hemodynamics after liver transplantation and the adoption of a sedentary *** this review we describe the most prevalent metabolic and cardiovascular complications present after liver transplantation,as well as proposing management strategies.

关键词： Solid organ transplantation Hypertension New-onset diabetes after transplantation Obesity Orthotopic liver transplantation Post-transplantation metabolic syndrome

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Physical activity decreases in patients on the liver transplant waiting list and influences postoperative outcome-a prospective cohort study

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Hepatobiliary Surgery and Nutrition 2024年第2期13卷 229-240,I0009-I0010页

作者： Christian T.J.Magyar Lea Bühlmann chiara becchetti Lara Beekman Daniel Candinas Guido Beldi Corina Kim-Fuchs Annalisa Berzigotti Vanessa Banz Department of Visceral Surgery and Medicine InselspitalBern University HospitalUniversity of BernBernSwitzerland

Background:Physical deconditioning affects patients suffering from end-stage liver disease(ESLD).Liver transplantation(LT)is the only curative option for *** evidence suggests that pre-habilitation is beneficial in reducing post-surgical morbidity and *** investigated physical activity(PA)in patients awaiting LT in a country with long waiting ***:Prospective,single center,longitudinal study in Bern,Switzerland between June 2019 and February 2020(halted due to SARS-CoV-2 pandemic),with follow-up data up to six months *** were instructed to use a wrist tracker(FitBit)to monitor PA,which was assessed using mixed-effects generalized linear *** study was approved by the local ethics committee(BASEC ID 2019-00606).Results:Thirty-five patients were included[71%male,median 59 years,body mass index(BMI)28 kg/m^(2),lab Model End-Stage Liver Disease(MELD)11],17(49%)pre-frail and 5(14%)frail according to the Liver Frailty Index(LFI).Twenty-eight patients underwent transplantation with 0 ninety-day mortality and 15(53.6%)composite adverse clinical *** daily steps were 4,661[interquartile range(IQR),1,685-8,609]and weekly moderate PA(MPA)was 41 min(IQR,0-127 min).Longitudinal analysis showed that female patients and patients on nutritional support had an increase in MPA between weeks 20 and 40.A significant decrease was seen in MPA after week 40,whilst no significant association was seen with age,Child-Pugh Score,LFI or quality of life at time of *** was significantly associated with the occurrence of the composite clinical endpoint after week 30 of waiting time(odds ratio 0.882,P=0.026).World Health Organization(WHO)-recommended MPA was significantly associated with less adverse composite clinical outcomes(P<0.001).Conclusions:In patients listed for LT,MPA decreased over time,showing a significant association with adverse outcome,specifically after week 30 on the waiting *** data support the implem

关键词： Sarcopenia liver disease solid organ transplant physical activity(PA) outcome

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Management of bacterial infection in the liver transplant candidate

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World Journal of Hepatology 2018年第2期10卷 222-230页

作者： Alberto Ferrarese Alberto Zanetto chiara becchetti Salvatore Stefano Sciarrone Sarah Shalaby Giacomo Germani Martina Gambato Francesco Paolo Russo Patrizia Burra Marco Senzolo Multivisceral Transplant Unit Department of Surgery Oncology and Gastroenterology Padua University Hospital

Bacterial infection(BI) is a common cause of impairment of liver function in patients with cirrhosis, especially in the liver transplant candidates. These patients share an immunocompromised state and increased susceptibility to develop community and hospital-acquired infections. The changing epidemiology of BI, with an increase of multidrug resistant strains, especially in healthcareassociated settings, represents a critical issue both in the waiting list and in the post-operative management. This review focused on the role played by BI in patients awaiting liver transplantation, evaluating the risk of drop-out from the waiting list, the possibility to undergo liver transplantation after recovery from infection or during a controlled infection.

关键词： Cirrhosis Portal hypertension Bacterial infection Liver transplantation

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Direct-acting antivirals and hepatocellular carcinoma occurrence and recurrence in hepatitis C virus-related liver cirrhosis: fact or fiction

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Hepatoma Research 2018年第11期4卷 16-31页

作者： Alberto Zanetto Sarah Shalaby Alberto Ferrarese chiara becchetti Salvatore Sciarrone Giacomo Germani Marco Senzolo Martina Gambato Francesco Paolo Russo Patrizia Burra Multivisceral Transplant Unit Department of SurgeryOncology and GastroenterologyPadua University HospitalPadua 35128Italy

Since the widespread adoption of new direct-acting antiviral agents (DAAs), the approach to hepatitis C virus (HCV) infection has changed profoundly as almost all patients can be cured regardless of the stage of their liver disease. On the other hand, there are a few conflicting reports on the risk of hepatocellular carcinoma (HCC) occurring and recurring in patients given DAA-based therapy. The present review focuses on the latest and most relevant literature providing evidence on the occurrence and recurrence of HCC after HCV antiviral treatment with the new DAAs. Retaining the distinction between HCC occurrence and recurrence, we also discuss its patterns of presentation and speculate on the possible pathogenic mechanisms. We offer our personal viewpoints on this important issue, which has kept clinicians second-guessing in real-world clinical practice, when dealing with HCV eradication in the setting of advanced liver disease in this interferon-free era.

关键词： Hepatitis C virus direct-acting antiviral agent occurrence recurrence hepatocellular carcinoma and liver cirrhosis

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Therapeutic targeting of cellular prion protein: toward the development of dual mechanism anti-prion compounds

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Neural Regeneration Research 2025年第4期20卷 1009-1014页

作者： Antonio Masone chiara Zucchelli Enrico Caruso Giovanna Musco Roberto Chiesa Laboratory of Prion Neurobiology Department of NeuroscienceIstituto di Ricerche Farmacologiche Mario Negri IRCCSMilanItaly Biomolecular NMR Unit Division of Genetics and Cell BiologyIRCCS Ospedale San RaffaeleMilanItaly Department of Biotechnology and Life Sciences University of InsubriaVareseItaly

PrPSc,a misfolded,aggregation-prone isoform of the cellular prion protein(PrPC),is the infectious prion agent responsible for fatal neurodegenerative diseases of humans and other *** adopt different pathogenic conformations(prion strains),which can be resistant to potential drugs,or acquire drug resistance,posing challenges for the development of effective *** PrPCis the obligate precursor of any prion strain and serves as the mediator of prion neurotoxicity,it represents an attractive therapeutic target fo r prion *** this minireview,we briefly outline the approaches to target PrPCand discuss our recent identification of Zn(Ⅱ)-Bn PyP,a PrPC-targeting porphyrin with an unprecedented bimodal mechanism of *** argue that in-depth understanding of the molecular mechanism by which Zn(Ⅱ)-Bn PyP targets PrPCmay lead toward the development of a new class of dual mechanism anti-prion compounds.

关键词： anti-prion drug anti-PrPC antibody antisense oligonucleotide neurodegeneration pharmacological chaperone porphyrin prion disease PrPC degrader PrPC shedding zinc finger repressor

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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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Quantifying Environmental Impacts of Temporary Housing at the Urban Scale: Intersection of Vulnerability and PostHurricane Relief in New Orleans

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International Journal of Disaster Risk Science 2019年第4期10卷 478-492页

作者： Claire McConnell chiara Bertolin Department of Architecture and Technology Norwegian University of Science and Technology(NTNU)7491 TrondheimNorway Department of Mechanical and Industrial Engineering Norwegian University of Science and Technology(NTNU)7491 TrondheimNorway

The increasing risk and exposure of people and assets to natural hazards and disasters suggests an increasing need for temporary housing following *** to natural hazards is dependent on the resources available to families or communities to prepare for and mitigate risk,influenced by social *** study seeks to quantify the total environmental impact of temporary housing deployment in New Orleans,using the catastrophic impact of Hurricane Katrina in southern Louisiana in August 2005 as a case *** employ a novel approach to estimate displacement period and take into account social vulnerability across New Orleans neighborhoods to better understand the scale of post-disaster relief and its global warming *** methodology implemented in this study comprises three steps:a risk assessment,a life cycle assessment,and a resulting total impact *** demonstrate the considerable risk of greenhouse gas emissions and energy impacts from temporary housing deployment linked to hurricane ***,we show that environmental impact is highly sensitive to displacement period and find the current methodology of anticipating temporary housing use by hazard alone to be ***,the approach presented in this article provides tools to politicians and disaster risk professionals that allow for resource investment planning to decrease social vulnerability,thus enhancing resilience and adaptive capacity in a more homogeneous way at the urban scale.

关键词： Disaster risk Global warming potential Hurricane Katrina Life cycle assessment New Orleans Social vulnerability Temporary housing

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Focus on cardiac troponin complex:From gene expression to cardiomyopathy

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Genes & Diseases 2024年第6期11卷 115-134页

作者： Rosetta Ragusa chiara Caselli Institute of Clinical Physiology CNRvia Moruzzi 1Pisa 56124Italy Fondazione Toscana Gabriele Monasterio via Moruzzi 1Pisa 56124Italy

The cardiac troponin complex(cTn)is a regulatory component of *** consists of three subunits:cardiac troponin C(cTnC),which confers Ca2+sensitivity to muscle;cTnl,which inhibits the interaction of cross-bridge of myosin with thin filament during dias-tole;and cTnT,which has multiple roles in sarcomere,such as promoting the link between the cTnl-cTnC complex and tropomyosin within the thin filament and influencing Ca2+sensi-tivity of cTn and force development during *** that interfere with inter-actions within cTn and/or other thin filament proteins can be key factors in the regulation of cardiac *** conditions include alterations in myoflament Caz+sensitivity,direct changes in cTn function,and triggering downstream events that lead to adverse cardiac remodeling and impairment of heart *** review describes gene expression and post-translational modifications of cTn as well as the conditions that can adversely affect the deli-cate balance among the components of cTn,thereby promoting contractile dysfunction.

关键词： Cardiac troponin Cardiomyopathy Genemutation Post-translational modification Therapy

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Comparison of laboratory and field electrical resistivity measurements of a gypsum rock for mining prospection applications

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International Journal of Mining Science and Technology 2019年第6期29卷 841-849页

作者： chiara Caselle Sabrina Bonetto Cesare Comina Department of Earth Science (DST) Torino University

Geophysical surveys are frequently applied in mining prospection to detect the presence and volume of ore bodies of different ***,in gypsum ore bodies exploitation,electrical resistivity measurements are usually the most used ***,it has been observed that different electrical resistivity values can be obtained depending on geometrical features and composition of ***,electrical resistivity of gypsum rocks depends on several parameters,such as gypsum purity,nature of secondary minerals,porosity,saturation and interstitial fluid *** and hydrogeological setting,in particular,were recognized as the most influencing *** conditions of gypsum rock masses are also very relevant for exploitability,safety conditions and economic feasibility and should be accurately known during the prospection and planning phases of the *** this work,a relationship between electrical resistivity and saturation degree of gypsum is *** possibility to estimate gypsum porosity with the use of this relationship is also *** reliability of laboratory measurements is finally verified in comparison with field and modelled resistivity *** reported results underline the potentiality of the proposed approach to obtain a reliable characterization of the studied ore body.

关键词： Gypsum rock Electrical resistivity Saturation Porosity Archie ERT Quarry

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In vitro rumen fermentation of feed substrates added with chestnut tannins or an extract from Stevia rebaudiana Bertoni

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Animal Nutrition 2020年第1期6卷 54-60页

作者： chiara Sarnataro Mauro Spanghero Department of Agricultural FoodEnvironmental and Animal SciencesUniversity of UdineVia Sondrio2/A33100UdineItaly

Rumen fermentation parameters and microbiota were evaluated in 3 in vitro rumen fermentation experiments after addition of chestnut tannins(CWT)or an extract from Stevia rebaudiana Bertoni(SB)to substrates.A control(CTR)substrate was fermented alone or added with 1.5%of CWT or SB extracts in a batch culture system(Exp.1,fermentation in 500 mL for 24 h)and in a subsequent continuous culture system(Exp.2,fermentation in 2 L bottles for 9 d).Experiment 3 used the fermentation system of Exp.1 and tested 7 doses of each extract added to CTR(additions of 0.2%,0.4%,0.6%,0.8%,1.0%,1.2%and 1.4%for48 h).The addition of CWT lowered(P<0.01)the in vitro rumen ammonia concentration in all experiments and reduced the protozoa counts in Exp.1(P<0.05).In contrast,the SB extract did not modify the ammonia concentrations,but significantly lowered the protozoa counts in all 3 experiments(reduction of 47%and 20%in Exp.1 and 2,P<0.05;and a quadratic reduction in Exp.3,R^2=0.63,P<0.01).Neither extract affected the fermentation in terms of gas production(Exp.1 and 3)nor volatile fatty acids(VFA)yield(Exp.1 and 2),if we exclude a reduction at the highest CWT concentration in *** in VFA profile were induced by CWT and were limited to reductions in the iso-valerate(P<0.01,in Exp.2)and iso-butyrate levels(P<0.01,Exp.2).The CWT increased the abundance of Prevotella ruminicola and Selenomonas ruminantium and decreased that of Ruminobacter amylophilus(P<0.01,P<0.05 and P<0.05,respectively).The SB extract increased the relative abundance of Treponema saccarophylum(P<0.05).Both of the studied substances had an impact on rumen metabolism,with SB reducing protozoa counts and CWT lowering the rumen ammonia *** effects of both extracts on the rumen were appreciable at low dietary doses,and the negative impacts on fermentation were limited to the reduction in protein degradation with the addition of CWT.

关键词： Rumen Ammonia Protozoa Chestnut tannin Stevia rebaudiana Bertoni

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