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Paradoxical association between dyspepsia and autoimmune chronic atrophic gastritis:Insights into mechanisms,pathophysiology,and treatment options

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World Journal of Gastroenterology 2023年第23期29卷 3733-3747页

作者： Roberta elisa Rossi Alessandra Elvevi Valentina Sciola Francesco Vito Mandarino Silvio Danese Pietro Invernizzi Sara Massironi Gastroenterology and Endoscopy Unit IRCCS Humanitas Research HospitalRozzano 20089MilanItaly Gastroenterology Unit Fondazione IRCCS San Gerardo dei TintoriMonza 20900Italy and Department of Medicine and SurgeryUniversity of Milano-BicoccaMonza 20900Italy Gastroenterology and Endoscopy Unit Fondazione IRCCS Ca’Granda Ospedale Maggiore PoliclinicoMilano 20100Italy Department of Gastroenterology and Endoscopy IRCCS Ospedale San RaffaeleMilan 20132Italy School of Medicine Vita-Salute San Raffaele UniversityMilan 20132Italy

BACKGROUND Autoimmune gastritis(AIG)is a progressive,chronic,immune-mediated inflammatory disease characterized by the destruction of gastric parietal cells leading to hypo/anacidity and loss of intrinsic *** symptoms such as dyspepsia and early satiety are very common,being second in terms of frequency only to anemia,which is the most typical feature of *** To address both well-established and more innovative information and knowledge about this challenging *** An extensive bibliographical search was performed in PubMed to identify guidelines and primary literature(retrospective and prospective studies,systematic reviews,case series)published in the last 10 *** A total of 125 records were reviewed and 80 were defined as fulfilling the *** AIG can cause a range of clinical manifestations,including *** pathophysiology of dyspepsia in AIG is complex and involves changes in acid secretion,gastric motility,hormone signaling,and gut microbiota,among other *** dyspeptic symptoms of AIG is challenging and there are no specific therapies targeting dyspepsia in *** proton pump inhibitors are commonly used to treat dyspepsia and gastroesophageal reflux disease,they may not be appropriate for *** agents,antidepressant drugs,and non-pharmacological treatments may be of help,even if not adequately evidence-based supported.A multidisciplinary approach for the management of dyspepsia in AIG is recommended,and further research is needed to develop and validate more effective therapies for dyspepsia.

关键词： Dyspepsia Dyspeptic symptoms Gastro-intestinal symptoms Autoimmune gastritis Chronic autoimmune atrophic gastritis Treatment

Identification of a novel germline missense mutation of the androgen receptor in African American men with familial prostate cancer

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Asian Journal of Andrology 2010年第3期12卷 336-343,I0008,I0009页

作者： Si-Yi Hu Tao Liu Zhen-Zhen Liu elisa Ledet Cruz Velasco-Gonzalez Diptasri M Mandal Shahriar Koochekpour Stanley S Scott Cancer Center Louisiana State University Health Sciences Center New Orleans LA 70112 USA Department of Genetics Louisiana State University Health Sciences Center New Orleans LA 70112 USA School of Public Health Louisiana State University Health Sciences Center New Orleans LA 70112 USA 4Department of Microbiology and Immunology Department of Urology Department of Biochemistry and Molecular Biology Louisiana State University Healt Sciences Center New Orleans LA 70112 USA

Race, family history and age are the unequivocally accepted risk factors for prostate cancer （PCa）. Androgen receptor （AR）-dependent signaling is an important element in prostate carcinogenesis and its progression to metastatic disease. We examined the possibility of genomic changes in the AR in association with familial PCa in African Americans who have a higher incidence and mortality rate and a clinically more aggressive disease presentation than Caucasians. Genomic DNAs of 60 patients from 30 high-risk African American and Caucasian families participating in the Louisiana State University Health Sciences Center genetic linkage study of PCa were studied. Exon-specific polymerase-chain reaction, bi-directional automated sequencing and restriction enzyme genotyping were used to analyze for mutations in the coding region of the AR gene. We identified a germline AR （A1675T）（T559S） substitution mutation in the DNA-binding domain in three PCa-affected members of an African- American family with a history of early-onset disease. The present study describes the first AR germline mutation in an African-American family with a history of familial PCa. The AR （T559S） mutation may contribute to the disease by altering AR DNA-binding affinity and/or its response to androgens, non-androgenic steroids or anti-androgens. Additional studies will be required to define the frequency and contribution of the AR （A 1675T） allele to early-onset and/or familial PCa in African Americans.

关键词： African Americans androgen receptor familial prostate cancer germline mutation

Complete pathological response in locally advanced non-small-cell lung cancer patient: A case report

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World Journal of Clinical Cases 2021年第20期9卷 5540-5546页

作者： elisabetta Parisi Donatella Arpa Giuglia Ghigi Simona Micheletti elisa Neri Luca Tontini Martina Pieri Antonino Romeo Radiotherapy Unit IRCCS Istituto Scientifico Romagnolo per lo Studio dei Tumori(IRST)"Dino Amadori"Meldola 47014Italy

BACKGROUND Chemotherapy and radiotherapy followed by durvalumab is currently the standard treatment for locally advanced node-positive non-small-cell lung cancer(NSCLC).We describe the case of a patient with locally advanced node-positive NSCLC(LA-NSCLC)treated in a phase II prospective protocol with chemotherapy,accelerated hypofractionated radiotherapy(AHRT)and surgery in the preimmunotherapy *** SUMMARY A 69-year-old male,ex-smoker(20 PY),with a Karnofsky performance status of 90,was diagnosed with locally advanced squamous cell lung *** was staged by total body computed tomography(CT)scanning,and integrated 18Ffluorodeoxyglucose positron emission tomography/CT scan[cT4 cN3 cM0,stage IIIC according to TNM(tumor-node-metastasis)8th edition]and received AHRT between chemotherapy cycles,in accordance with the study protocol(EudractCT registration 2008-006525-14).At the end of the study the patient underwent surgery,which was not part of the protocol,and showed a complete pathological *** This case report confirms that AHRT can be used successfully to treat primary LA-NSCLC with bilateral mediastinal lymph node *** case is of particular interest because of the pathological response after AHRT and the lack of surgical *** hypothesize that this radiotherapeutic approach,with its proven efficacy,could be delivered as a short course reducing treatment costs,increasing patient compliance and reducing *** are currently investigating the possibility of combining hypofractionation,chemotherapy and immunotherapy for patients with LA-NSCLC.

关键词： Locally advanced non-small-cell lung cancer Hypofractionated radiotherapy Chemoradiotherapy Complete pathological response Immunotherapy Case report

Rectal neuroendocrine tumors:Current advances in management,treatment,and surveillance

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World Journal of Gastroenterology 2022年第11期28卷 1123-1138页

作者： Camilla Gallo Roberta elisa Rossi Federica Cavalcoli Federico Barbaro Ivo Boškoski Pietro Invernizzi Sara Massironi Division of Gastroenterology and Center for Autoimmune Liver Diseases Department of Medicine and SurgeryUniversity of Milano-BicoccaEuropean Reference Network on Hepatological DiseasesSan Gerardo HospitalMonza 20900Italy Division of HPB Surgery Hepatology and Liver TransplantationDepartment of Pathophysiology and TransplantationUniversity of MilanENETS Center of ExcellenceFondazione IRCCS Istituto Nazionale Tumori(INTNational Cancer Institute)Milan 20133Italy Diagnostic and Therapeutic Endoscopy Unit Fondazione IRCCS Istituto Nazionale TumoriMilan 20133Italy Digestive Endoscopy Unit UniversitàCattolica del Sacro Cuore di RomaCenter for Endoscopic Research Therapeutics and TrainingFondazione Policlinico Universitario Agostino Gemelli IRCSSRome 00168Italy

Rectal neuroendocrine neoplasms(r-NENs)are considered among the most frequent digestive NENs,together with small bowel *** incidence has increased over the past few years,and this is probably due to the widespread use of endoscopic screening for colorectal cancer and the advanced endoscopic procedures available *** to the current European Neuroendocrine Tumor Society(ENETS)guidelines,well-differentiated r-NENs smaller than 10 mm should be endoscopically removed in view of their low risk of local and distant invasion.R-NENs larger than 20 mm are candidates for surgical resection because of their high risk of distant spreading and the involvement of the muscularis *** is an area of uncertainty regarding tumors between 10 and 20 mm,in which the metastatic risk is intermediate and the endoscopic treatment can be *** removed,the indications for surveillance are scarce and poorly codified by international guidelines,therefore in this paper,a possible algorithm is proposed.

关键词： Rectal neuroendocrine tumors Endoscopy Endoscopic submucosal dissection Resectable advanced disease Systemic therapy

Nonalcoholic fatty liver disease and aging: Epidemiology to management

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World Journal of Gastroenterology 2014年第39期20卷 14185-14204页

作者： Marco Bertolotti Amedeo Lonardo Chiara Mussi Enrica Baldelli elisa Pellegrini Stefano Ballestri Dante Romagnoli Paola Loria Department of Biomedical Metabolic and Neural Sciences Nuovo Ospedale Civile di Modena University of Modena and Reggio Emilia and Azienda USL of Modena Baggiovara 41126 Modena Italy Division of Internal Medicine Pavullo Hospital 41026 Pavullo (MO) Italy

Nonalcoholic fatty liver disease(NAFLD) is common in the elderly, in whom it carries a more substantial burden of hepatic(nonalcoholic steatohepatitis, cirrhosis and hepatocellular carcinoma) and extra-hepatic manifestations and complications(cardiovascular disease, extrahepatic neoplasms) than in younger age groups. Therefore, proper identification and management of this condition is a major task for clinical geriatricians and geriatric hepatologists. In this paper, the epidemiology and pathophysiology of this condition are reviewed, and a full discussion of the link between NAFLD and the aspects that are peculiar to elderly individuals is provided; these aspects include frailty, multimorbidity, polypharmacy and dementia. The proper treatment strategy will have to consider the peculiarities of geriatric patients, so a multidisciplinary approach is mandatory. Non-pharmacological treatment(diet and physical exercise) has to be tailored individually considering the physical limitations of most elderly people and the need for an adequate caloric supply. Similarly, the choice of drug treatment must carefully balance the benefits and risks in terms of adverse events and pharmacological interactions in the common context of both multiple health conditions and polypharmacy. In conclusion, further epidemiological and pathophysiological insight is warranted. More accurate understanding of the molecular mechanisms of geriatric NAFLD will help in identifying the most appropriate diagnostic and therapeutic approach for individual elderly patients.

关键词： Adipose tissue Atherosclerosis Aortic valve sclerosis Autonomic dysfunction Arrhythmia Cirrhosis Dementia Falls Frailty Hepatocellular carcinoma Microbiota Nuclear receptors Pathogenesis Sarcopenia Treatment

Circulating tumor DNAs and non-coding RNAs as potential biomarkers for hepatocellular carcinoma diagnosis, prognosis and response to therapy

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Hepatoma Research 2019年第2期5卷 12-33页

作者： Paola Guerriero Farzaneh Moshiri Laura Lupini Silvia Sabbioni Massimo Negrini elisa Callegari Department of Morphology Surgery and Experimental MedicineUniversity of FerraraFerrara 44121Italy Department of Molecular Medicine School of Advanced Technologies in MedicineTehran University of Medical SciencesTehran 11369Iran Department of Life Sciences and Biotechnologies University of FerraraFerrara 44121Italy

Hepatocellular carcinoma(HCC)is the second leading cause of cancer-related deaths worldwide and despite improvement in therapeutic approaches,prognosis remains *** can be partly attributed to the fact that the majority of HCCs are diagnosed at intermediate or advanced *** of circulating biomarkers able to detect HCC at early stages could improve patients'*** present,however,alpha fetoprotein or des-g-carboxyprothrombin are unable to reliably detect HCC at early stages and better circulating biomarkers are *** tumor DNA(ctDNA)and non-coding RNAs(ncRNAs)are emerging as promising biomarkers to achieve the *** and epigenetic alterations in ctDNA allow to pinpoint tumor-specific biomarkers,reveal tumor heterogeneity,help monitor tumor evolution over time and assess therapy *** remains to be fully evaluated the possibility of detecting these biomarkers at early tumor *** ncRNAs are quantitative biomarkers with potential use in diagnostic,prognostic and predictive clinical *** may help to reveal HCC at early ***,because of heterogeneous and sometimes conflicting reported results,they still require validation and standardization of pre-analytical and analytical approaches before clinical applications could be envisaged.

关键词： Liquid biopsy hepatocellular carcinoma circulating tumor DNA non-coding RNA diagnosis prognosis therapy response

Childhood absence epilepsy and benign epilepsy with centro-temporal spikes: a narrative review analysis

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World Journal of Pediatrics 2017年第2期13卷 106-111页

作者： Alberto Verrotti Renato D'Alonzo Victoria elisa Rinaldi Sara Casciato Alfredo D'Aniello Giancarlo Di Gennaro Department of Pediatrics University of L'AquilaL'AquilaItaly Department of Paediatrics University of PerugiaPerugiaItaly Department of Neurology and Psychiatry University of Rome'La Sapienza'RomeItaly IRCCS NEUROMED Pozzilli(IS)Italy

Background:Recent studies have shown a possible coexistence of absence seizures with other forms of *** purpose of this study was to ascertain the possible contemporary or subsequent presence of childhood absence epilepsy (CAE) and benign epilepsy with centro-temporal spikes (BECTS) in pediatric epileptic *** sources:A PubMed systematic search indexed for MEDLINE,PubMed and EMBASE was undertaken to identify studies in children including articles written between 1996 and *** studies,meta-analysis and case reports were *** list of references of all the relevant articles was also *** date of our last search was December ***:Review of the literature revealed 19 cases,8 females and 11 males,reporting a consecutive or contemporary coexistence of CAE and BECTS within the same ***'s age ranged between 4 and 12 *** out of 19 patients presented concomitant features of both syndromes,whereas 16 patients experienced the two syndromes at different ***:BECTS and CAE may be pathophysiologically related,and the two epileptic phenotypes may indicate a neurobiological *** studies are needed to elucidate a probable genetic or functional link between partial and primarily generalized electro-clinical patterns in idiopathic childhood epilepsies.

关键词： absence seizures benign epilepsy with centro-temporal spikes childhood abscence epilepsy

Associations between y-glutamyl transferase, metabolic abnormalities and inflammation in healthy subjects from a population-based cohort: A possible implication for oxidative stress

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World Journal of Gastroenterology 2005年第45期11卷 7109-7117页

作者： Simona Bo Roberto Gambino Marilena Durazzo Sabrina Guidi elisa Tiozzo Federica Ghione Luigi Gentile Maurizio Cassader Gian Franco Pagano Department of Internal Medicine Diabetic Clinic

AIM: To examine the relationships between γ -glutamyltransferase (GGT), alanine-aminotransferase (ALT),aspartate-aminotransferase (AST) and various metabolic parameters, C-reactive protein (CRP) and an oxidative stress marker (nitrotyrosine, NT) in subjects without any metabolic abnormalities from a population-based ***: Two hundred and five subjects with normal body mass index (BMI), glucose tolerance, and without any metabolic abnormality were studied out of 1339subjects, without known liver diseases, alcohol abuse or use of hepatotoxic drugs, who are representative of the 45-64 aged population of Asti (north-western Italy).RESULTS: In all patients metabolic parameters and hs-CRP levels linearly increase from the lowest to the highest ALT and GGT tertiles, while in subjects without metabolic abnormalities, there is a significant association between fasting glucose, uric acid, waist circumference,hs-CRP, triglyceride values, and GGT levels. In these subjects, male sex, higher hs-CRP and glucose levels are associated with GGT levels in a multiple regression model, after adjustments for multiple *** the same model, median NT levels are significantly associated with the increasing GGT tertile (β = 1.06;95%CI 0.67-1.45), but not with the AST and ALT *** a multiple regression model, after adjusting for age,sex, BMI, waist, smoking, and alcohol consumption, both NT (β = 0.05; 95%CI 0.02-0.08) and hs-CRP levels (β =0.09; 95%CI 0.03-0.15) are significantly associated with fasting ***: GGT, an easy, universally standardized and available measurement, could represent an early marker of sub-clinical inflammation and oxidative stress in otherwise healthy individuals. Prospective studies are needed to establish if GGT could predict future diabetes in these subjects.

关键词： Alanine aminotransferase Aspartate aminotransferase Body mass index C-reactive protein γ-Glutamyl transferase Metabolic syndrome Nitrotyrosine

Narrow-band imaging with magnifying endoscopy is accurate for detecting gastric intestinal metaplasia

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World Journal of Gastroenterology 2013年第17期19卷 2668-2675页

作者： Edoardo Savarino Marina Corbo Pietro Dulbecco Lorenzo Gemignani elisa Giambruno Luca Mastracci Federica Grillo Vincenzo Savarino Gastroenterology Unit Department of Surgical Oncological and Gastroenterological Sciences University of Padua Gastroenterology Unit Department of Internal Medicine University of Genoa Department of Anatomic Pathology University of Genoa

AIM:To investigate the predictive value of narrowband imaging with magnifying endoscopy (NBI-ME) for identifying gastric intestinal metaplasia (GIM) in unselected patients. MethODS:We prospectively evaluated consecutive patients undergoing upper endoscopy for various indications, such as epigastric discomfort/pain, anaemia, gastro-oesophageal reflux disease, suspicion of peptic ulcer disease, or chronic liver diseases. Patients underwent NBI-ME, which was performed by three blinded, experienced endoscopists. In addition, five biopsies (2 antrum, 1 angulus, and 2 corpus) were taken and examined by two pathologists unaware of the endoscopic findings to determine the presence or absence of GIM. The correlation between light blue crest (LBC) appearance and histology was measured. Moreover, we quantified the degree of LBC appearance as less than 20% (+), 20%-80% (++) and more than 80% (+++) of an image field, and the semiquantitative evaluation of LBC appearance was correlated with IM percentage from the histological findings. RESULTS:We enrolled 100 (58 F/42 M) patients who were mainly referred for gastro-esophageal reflux disease/dyspepsia (46%), cancer screening/anaemia (34%), chronic liver disease (9%), and suspected celiac disease (6%); the remaining patients were referred for other indications. The prevalence of Helicobacter pylori (H. pylori ) infection detected from the biopsies was 31%, while 67% of the patients used proton pump inhibitors. LBCs were found in the antrum of 33 patients (33%); 20 of the cases were classified as LBC+, 9 as LBC++, and 4 as LBC+++. LBCs were found in the gastric body of 6 patients (6%), with 5 of them also having LBCs in the antrum. The correlation between the appearance of LBCs and histological GIM was good, with a sensitivity of 80% (95%CI:67-92), a specificity of 96% (95%CI:93-99), a positive predictive value of 84% (95%CI:73-96), a negative predictive value of 95% (95%CI:92-98), and an accuracy of 93% (95%CI:90-97). The NBI-ME ex

关键词： Narrow-band imaging Magnification Gastric intestinal metaplasia Light blue crest Gastric cancer Endoscopy Precancerous conditions Gastric biopsy