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Risk factors associated with pancreatic fistula after distal pancreatectomy, which technique of pancreatic stump closure is more beneficial?

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World Journal of Gastroenterology 2007年第38期13卷 5096-5100页

作者： Marco Pericoli Ridolfini Sergio Alfieri Stavros Gourgiotis dario di miceli Fabio Rotondi Giuseppe Quero Roberta Manghi Giovanni Battista Doglietto Department of Surgical Sciences Gemelli University Hospital Catholic University of the Sacred Heart School of Medicine Rome Italy Hepatobiliary and Pancreatic Surgery Department Royal London Hospital United Kingdom

AIM: To identify risk factors related to pancreatic fistula in patients undergoing distal pancreatectomy (DP) and to determine the effectiveness of using a stapled and a sutured closed of pancreatic stump. METHODS: Sixty-four patients underwent DP during a 10-year period. Information regarding diagnosis, operative details, and perioperative morbidity or mortality was collected. Eight risk factors were examined. RESULTS: Indications for DP included primary pancreatic disease (n = 38, 59%) and non-pancreatic malignancy (n = 26, 41%). Postoperative mortality and morbidity rates were 1.5% and 37% respectively; one patient died due to sepsis and two patients required a reoperation due to postoperative bleeding. Pancreatic fistula was developed in 14 patients (22%); 4 of fistulas were classified as Grade A, 9 as Grade B and only 1 as Grade C. Incidence of pancreatic fistula rate was significantly associated with four risk factors: pathology, use of prophylactic octreotide therapy, concomitant splenectomy, and texture of pancreatic parenchyma. The role that technique (either stapler or suture) of pancreatic stump closure plays in the development of pancreatic leak remains unclear. CONCLUSION: The pancreatic fistula rate after DP is 22%. This is reduced for patients with non-pancreatic malignancy, fibrotic pancreatic tissue, postoperative prophylactic octreotide therapy and concomitant splenectomy.

关键词： Pancreas distal pancreatectomy Pancreatic fistula

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What does irritable bowel syndrome share with non-alcoholic fatty liver disease?

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World Journal of Gastroenterology 2013年第33期19卷 5402-5420页

作者： Antonella Scalera Matteo Nicola dario di Minno Giovanni Tarantino Department of Clinical Medicine and Surgery Federico Ⅱ University Medical School of Naples INT "Fondazione Pascale" - Cancer Research Center of Mercogliano

Non-alcoholic fatty liver disease(NAFLD)and irritable bowel syndrome(IBS)are two very common diseases in the general *** date,there are no studies that highlight a direct link between NAFLD and IBS,but some recent reports have found an interesting correlation between obesity and IBS.A systematic PubMed database search was conducted highlighting that common mechanisms are involved in many of the local and systemic manifestations of NAFLD,leading to an increased cardiovascular risk,and IBS,leading to microbial dysbiosis,impaired intestinal barrier and altered intestinal *** is not known when considering local and systemic inflammation/immune system activation,which one has greater importance in NAFLD and IBS ***,the nervous system is *** fact,inflammation participates in the development of mood disorders,such as anxiety and depression,characteristics of obesity and consequently of NAFLD and,on the other hand,in intestinal hypersensitivity and dysmotility.

关键词： Non-alcoholic fatty liver disease Irritable bowel syndrome Low grade chronic inflammation Cytokines

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High prevalence of nonalcoholic fatty liver in patients with idiopathic venous thromboembolism

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World Journal of Gastroenterology 2010年第48期16卷 6119-6122页

作者： Matteo Nicola dario di Minno Antonella Tufano Anna Rusolillo Giovanni di Minno Giovanni Tarantino Department of Clinical and Experimental Medicine Federico II University Medical School of Naples

AIM:To assess the prevalence of nonalcoholic fatty liver disease (NAFLD) in patients with idiopathic venous thromboembolism (VTE). METHODS:In a case-control study,after excluding subjects with well-consolidated risk factors for VTE,idiopathic VTE was documented in 138 consecutive patients who were referred to our department. Two hundred and seventy-six healthy sex/age/body-massindex-matched subjects,without any clinical/instrumental evidence of VTE,served as controls. All underwent a clinical/laboratory/ultrasound assessment for the presence of metabolic syndrome and NAFLD. RESULTS:NAFLD was detected in 112/138 cases (81%) and in 84/276 controls (30%) [risk ratio:2.7,95% confidence interval (CI):2.2-3.2,P diopathic VTE. The high prevalence of NAFLD in VTE was also confirmed after adjustment for inherited thrombophilia. NAFLD was clearly predicted by VTE (odds ratio:1.8,95% CI:1.2-2.7,P < 0.0001).

关键词： Thromboembolism Metabolic syndrome Nonalcoholic fatty liver disease

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Contrast-enhanced ultrasound in differentiating malignant from benign portal vein thrombosis in hepatocellular carcinoma

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World Journal of Gastroenterology 2015年第32期21卷 9457-9460页

作者： Luciano Tarantino Pasquale Ambrosino Matteo Nicola dario di Minno Department of Surgery Interventional Hepatology Unit Andrea Tortora Hospital Department of Clinical Medicine and Surgery Federico II University Unit of Cell and Molecular Biology in Cardiovascular diseases Centro Cardiologico Monzino

Portal vein thrombosis(PVT) may occur in liver cirrhosis patients. Malignant PVT is a common complication in cirrhotic patients with concomitant hepatocellular carcinoma(HCC) and, in some cases, it may be even the initial sign of an undetected HCC. Detection of malignant PVT in a patient with liver cirrhosis heavily affects the therapeutic strategy. Gray-scale ultrasound(US) is widely unreliable for differentiating benign and malignant thrombi. Although effective for this differential diagnosis, fine-needle biopsy remains an invasive technique. Sensitivity of color-doppler US in detection of malignant thrombi is highly dependent on the size of the thrombus. Contrast-enhanced computed tomography(CT) and contrast-enhanced magnetic resonance(MRI) can be useful to assess the nature of portal thrombus, while limited data are currently available about the role of positron emission tomography(PET) and PET-CT. In contrast with CT, MRI, PET, and PET-CT, contrast-enhanced ultrasound(CEUS) is a fast, effective, well tolerated and cheap technique, that can be performed even in the same session in which the thrombus has been detected. CEUS can be performed bedside and can be available also in transplanted patients. Moreover, CT and MRI only yield a snapshot analysis during contrast diffusion, while CEUS allows for a continuous real-time imaging of the microcirculation that lasts several minutes, so that the whole arterial phase and the late parenchymal phase of the contrast diffusion can be analyzed continuously by real-time US scanning. Continuous real-time monitoring of contrast diffusion entails an easy detection of thrombus maximum enhancement. Moreover, continuous quantitative analyses of enhancement(wash in- wash out studies) by CEUS during contrast diffusion is nowadays available in most CEUS machines, thus giving a more sophisticated and accurate evaluation of the contrast distribution and an increased confidence in diagnosis in difficult cases. In conclusion, CEUS is av

关键词： Contrast-enhanced ultrasound Hepatocellular carcin

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Cost-effectiveness analysis of beta-blockers vs endoscopic surveillance in patients with cirrhosis and small varices

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World Journal of Gastroenterology 2014年第30期20卷 10464-10469页

作者： Lorenza di Pascoli Alessra Buja Massimo Bolognesi Sara Montagnese Angelo Gatta dario Gregori Carlo Merkel Hepatic Hemodynamic Laboratory and Clinica Medica 5 Department of MedicineUniversity of Padua35128 PadovaItaly Laboratory of Epidemiological Methodology and Biostatistics Department of Environmental Medicine and Public HealthUniversity of Padua35128 PadovaItaly

AIM: To evaluate the most cost-effectiveness strategy for preventing variceal growth and bleeding in patients with cirrhosis and small esophageal varices.

关键词： Pharmaco-economical analysis Cirrhosis Esophageal varices Variceal bleeding Primary prophylaxis

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Bariatric surgery and diabetes remission: Sleeve gastrectomy or mini-gastric bypass?

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World Journal of Gastroenterology 2013年第39期19卷 6590-6597页

作者： Marco Milone Matteo Nicola dario di Minno Maddalena Leongito Paola Maietta Paolo Bianco Caterina Taffuri dario Gaudioso Roberta Lupoli Silvia Savastano Francesco Milone Mario Musella Department of Advanced Biomedical Science University of Naples "Federico Ⅱ"80131 NaplesItaly

AIM:To investigate the weight loss and glycemic control status[blood glucose,hemoglobin A1c(HbA1c)and hypoglycaemic treatment].METHODS:The primary risk factor for type 2 diabetes is obesity,and 90%of all patients with type 2 diabetes are overweight or *** a remarkable effect of bariatric surgery is the profound and durable resolution of type 2 diabetes clinical manifestations,little is known about the difference among various weight loss surgical procedures on diabetes *** from patients referred during a 3-year period(from January2009 to December 2011)to the University of Naples"FedericoⅡ"diagnosed with obesity and diabetes were retrieved from a prospective *** patients were split into two groups according to the surgical intervention performed[sleeve gastrectomy(SG)and mini-gastric bypass(MGB)].Weight loss and glycemic control status(blood glucose,HbA1c and hypoglycaemic treatment)were ***:A total of 53 subjects who underwent sleeve gastrectomy or mini-gastric bypass for obesity and diabetes were screened for the inclusion in this *** these,4 subjects were excluded because of surgical complications,7 subjects were omitted because young surgeons conducted the operations and 11 subjects were removed because of the lack of *** obese patients were recruited for this study.A total of 15 subjects underwent SG(48.4%),and 16underwent MGB(51.6%).After adjusting for various clinical and demographic characteristics in a multivariate logistic regression analysis,high hemoglobin A1c was determined to be a negative predictor of diabetes remission at 12 mo(OR=0.366,95%CI:0.152-0.884).Using the same regression model,MGB showed a clear trend toward higher diabetes remission rates relative to SG(OR=3.780,95%CI:0.961-14.872).CONCLUSION:Although our results are encouraging regarding the effectiveness of mini-gastric bypass on diabetes remission,further studies are needed to provide definitive conclusions in selecting th

关键词： Bariatric surgery Sleeve Bypass Obesity and diabetes

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Computed tomography findings of pneumatosis and portomesenteric venous gas in acute bowel ischemia

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World Journal of Gastroenterology 2013年第39期19卷 6579-6584页

作者： Marco Milone Matteo Nicola dario di Minno Mario Musella Paola Maietta Vittorio Iaccarino Giovanni Barone Francesco Milone Department of Advanced Biomedical Science University "Federico Ⅱ" of Naples80131 NaplesItaly Department of Surgery "Fatebenefratelli" Hospital in Naples80123 NaplesItaly

AIM:To use more representative sample size to evaluate whether computed tomography(CT)scan evidence of the concomitant presence of pneumatosis and portomesenteric venous gas is a predictor of transmural bowel ***:Data from 208 patients who were referred for a diagnosis of bowel ischemia were retrospectively *** patients who underwent a surgical intervention following a diagnosis of bowel ischemia who also had a post-operative histological confirmation of such a diagnosis were *** were split into two groups according to the presence of histological evidence of transmural bowel ischemia(case group)or partial bowel ischemia(control group).CT images were reviewed for findings of ischemia,including mural thickening,pneumatosis,bowel distension,portomesenteric venous gas and arterial or venous ***:A total of 248 subjects who underwent surgery for bowel ischemia were *** the208 subjects enrolled in our study,transmural bowel necrosis was identified in 121 subjects(case group),and partial bowel necrosis was identified in 87 subjects(control group).Based on CT findings,including mural thickening,bowel distension,pneumatosis,pneumatosis plus portomesenteric venous gas and presence of thrombi or emboli,there were no significant differences between the case and control *** concomitant presence of pneumatosis and porto-mesenteric venous gas showed an odds ratio of 1.95(95%CI:0.491-7.775,P=0.342)for the presence of transmural *** presence of pneumatosis plus porto-mesenteric venous gas exhibited good specificity(83%)but low sensitivity(17%)in the identification of transmural bowel ***,the positive and negative predictive values were 60% and 17%,***:Although pneumatosis plus porto-mesenteric venous gas is associated with bowel ischemia,we have demonstrated that their co-occurrence cannot be used as diagnostic signs of transmural necrosis.

关键词： Bowel ischemia Pneumatosis Mesenteric venous gas Computed tomography

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Short-Term Response of Soil Microbial Biomass to different Chabazite Zeolite Amendments

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Pedosphere 2018年第2期28卷 277-287页

作者： Giacomo FERRETTI Katharina Maria KEIBLINGER dario di GIUSEPPE Barbara FACCINI Nicolò COLOMBANI Sophie ZECHMEISTER-BOLTENSTERN Massimo COLTORTI Micòl MASTROCICCO Deptartment of Physics and Earth Sciences University of Ferrara Via Saragat 1 Ferrara 44122 (Italy) Institute of Soil Research Department of Forest and Soil Sciences University of Natural Resources and Life Sciences Vienna (BOKU) Peter Jordan Strasse 82 Vienna 1190 (Austria) Consorzio Nazionale Interuniversitario per le Scienze del Mare (CoNISMa) Piazzale Flaminio Roma 900196 (Italy) Department of Environmental Biological and Pharmaceutical Sciences and Technologies Second University of Naples Caserta 81100(Italy)

Zeolitites (ZTs) are rocks containing more than 50% of zeolite minerals and are known to be a suitable material for agricultural purposes by improving soil physicochemical properties and nitrogen (N) use efficiency. However, little is known about their effects on soil microbial biomass. This study aimed to evaluate short-term effects of different chabazite-rich ZT (CHAZT) amendments on soil microbial biomass and activity. A silty-clay agricultural soil was amended in three different ways, including the addition of natural (5% and 15%) and NH_4^+-enriched (10%) CHAZT. Soil dissolved organic carbon (C), total dissolved N, NH_4^+, NO_3^-, NO_2^-, microbial biomass C and N, and ergosterol were measured periodically over 16 d in a laboratory incubation. To verify the microbial immobilization of the N derived from NH_4^+-enriched CHAZT, a high15N source was used for enriching the mineral to measure the microbial biomass δ15N signature. An increase in the ergosterol content was observed in the soil amended with 5% natural CHAZT. However, no similar result was observed in the soil amended with 15% natural CHAZT, suggesting that the fungal biomass was favored at a lower CHAZT application rate. In the soil amended with NH+ 4-enriched CHAZT, microbial biomass N was related to NO_3^-production over time and inversely related to NH_4^+, suggesting high nitrification process. Isotopic measurements on microbial biomass confirmed immediate assimilation of N derived from NH_4^+-enriched CHAZT. These results suggested that the NH_4^+-enriched CHAZT used in this study supplied an immediately available N pool to the microbial biomass.

关键词： ergosterol microbial biomass δ15N natural zeolite NH4+-enriched zeolite nitrification slow-release fertilizer

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Analysis of predictor equations for determining the blast-induced vibration in rock blasting

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International Journal of Mining Science and Technology 2019年第6期29卷 905-915页

作者： Marilena Cardu dario Coragliotto Pierpaolo Oreste diATI Politecnico di Torino 10129 TorinoItaly IGG-CNR Torino 10129Italy Lochaline Quartz Sand Ltd. Lochaline MinePA805LQ MorvernScotlandUnited Kingdom

The paper proposes a new empirical correlation designed to complement the‘‘site laws"currently used to evaluate the attenuation in the rock masses of vibrations induced by rock *** formula contains a deformed exponential known as the K-exponential,which seems to well represent a large number of both natural and artificial phenomena ranging from astrophysics to quantum mechanics,with some extension in the field of economics and *** validation of the formula was performed via the analysis of vibration data covering a number of case studies,which differed in terms of both operation and rock type.A total of 12 experimental cases were analysed and the proposed formulation exhibited a good performance in 11 of *** particular,the proposed law,which was built using blast test data,produced very good approximations of the points representing the vibration measurements and would thus be useful in organising production ***,the developed formula was found to work less well when a correlation obtained for a given site was applied to another presenting similar types of rocks and operations,and thus should not be employed in the absence of measurements from test data.

关键词： Rock blasting Vibrations Predictor equation Site law K-statistics K-exponential

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Interplay between metabolic dysfunction-associated fatty liver disease and renal function: An intriguing pediatric perspective

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World Journal of Gastroenterology 2024年第15期30卷 2081-2086页

作者： Michele Nardolillo Fabiola Rescigno Mario Bartiromo dario Piatto Stefano Guarino Pierluigi Marzuillo Emanuele Miraglia del Giudice Anna di Sessa Department of Woman Child and of General and Specialized SurgeryUniversitàdegli Studi della Campania“Luigi Vanvitelli”Naples 80138Italy

Over recent years,the nomenclature of non-alcoholic fatty liver disease has undergone significant ***,in 2020,an expert consensus panel proposed the term“Metabolic(dysfunction)associated fatty liver disease”(MAFLD)to underscore the close association of fatty liver with metabolic abnormalities,thereby highlighting the cardiometabolic risks(such as metabolic syndrome,type 2 diabetes,insulin resistance,and cardiovascular disease)faced by these patients since *** recently,this term has been further replaced with metabolic associated steatotic liver *** is worth noting that emerging evidence not only supports a close and independent association of MAFLD with chronic kidney disease in adults but also indicates its interplay with metabolic ***,comparable pediatric data remain *** the progressive and chronic nature of both diseases and their prognostic cardiometabolic implications,this editorial aims to provide a pediatric perspective on the intriguing relationship between MAFLD and renal function in childhood.

关键词： Metabolic(dysfunction)associated fatty liver disease Renal Function Children Obesity

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