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Comparative outcome of stapled trans-anal rectal resection and macrogol in the treatment of defecation disorders

World Journal of Gastroenterology 2011年第37期17卷 4199-4205页

作者： Ivano Biviano Danilo Badiali Laura Candeloro Fortunée Irene Irene Habib Massimo Mongardini Angelo Caviglia fiorella anzini Enrico S Corazziari Department of Medicine and Medical Specialties SAPIENZA RomeUniversity 00161 Rome Italy Department of Surgical Sciences Division of General Surgery L SAPIENZA Rome University 00161Rome Italy Departmental Operative Unit of Colonproctology Hospital San Camillo-Forlanini 00161 Rome Italy

AIM:To prospectively assess the eff icacy and safety of stapled trans-anal rectal resection(STARR) compared to standard conservative treatment,and whether preoperative symptoms and findings at defecography and anorectal manometry can predict the outcome of STARR.METHODS:Thirty patients(Female,28;age:51 ± 9 years) with rectocele or rectal intussusception,a defecation disorder,and functional constipation were submitted for STARR.Thirty comparable patients(Female,30;age 53 ± 13 years),who presented with symptoms of rectocele or rectal intussusception and were treated with macrogol,were assessed.Patients were interviewed with a standardized questionnaire at study enrollment and 38 ± 18 mo after the STARR procedure or during macrogol treatment.A responder was def ined as an absence of the Rome Ⅲ diagnostic criteria for functional constipation.Defecography and rectoanal manometry were performed before and after the STARR procedure in 16 and 12 patients,respectively.RESULTS:After STARR,53% of patients were responders;during conservative treatment,75% were responders.After STARR,30% of the patients reported the use of laxatives,17% had intermittent anal pain,13% had anal leakage,13% required digital facilitation,6% experienced defecatory urgency,6% experienced fecal incontinence,and 6% required re-intervention.During macrogol therapy,23% of the patients complained of abdominal bloating and 13% of borborygmi,and 3% required digital facilitation.No preoperative symptom,defecographic,or manometric finding predicted the outcome of STARR.Post-operative defecography showed a statistically significant reduction(P < 0.05) of the rectal diameter and rectocele.The postoperative anorectal manometry showed that anal pressure and rectal sensitivity were not significantly modified,and that rectal compliance was reduced(P = 0.01).CONCLUSION:STARR is not better and is less safe than macrogol in the treatment of defecation disorders.It could be considered as an alternative therapy in patients unresponsive to macrogol.

关键词：保守治疗聚乙二醇直肠肛门排便装订标准化安全性

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Prevalence of overweightedness in patients with gastro-esophageal reflux

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World Journal of Gastroenterology 2007年第34期13卷 4602-4605页

作者： Luca Piretta Federico Alghisi fiorella anzini Enrico Corazziari Dipartimento di Scienze Cliniche Gastroenterologia A Università di Roma "La Sapienza" Viale del Policlinico 155-00161 Roma Italy

AIM: To evaluate whether the prevalence of overweight and obese conditions is increased in gastro-esophageal reflux disease (GERD) patients (with 24-h pathological pH recordings) in comparison to general population. METHODS: A total of 196 consecutive patients (103 females, age range 18-83 years) with symptoms of gastro-esophageal reflux (GER) and 24-h pathological esophageal pH-metry. Body mass index (BMI) of the patients was calculated and its distribution (%) was compared with that of the Italian general population as assessed by National Bureau of Census (ISTAT). To evaluate the association of GERD with weight categories, the binomial test was employed. P < 0.05 was considered statistically significant. RESULTS: In males, overweightedness (BMI 25-25.9) was present in 43% of GERD patients vs 41.8% of Italian population (IP) (ns), obesity (BMI ≥ 30) in 10.9% vs 9.1% (ns). In females overweight was present in 34.9% of GERD patients vs 25.7% of IP (P < 0.01), obesity in 13.6% of GERD patients vs 9.1% of IP (P < 0.01). No statistically significant differences were noted in different age classes. CONCLUSION: In comparison to the Italian general population, the prevalence of overweightedness and obesity is increased in female but not in male patients with ascertained gastro-esophageal reflux disease.

关键词：食管回流肥胖症超重体重

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Default rules in investment decision-making:trait anxiety and decision-making styles

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Financial Innovation 2022年第1期8卷 795-820页

作者： Elisa Gambetti Micaela Maria Zucchelli Raffaella Nori fiorella Giusberti Department of Psychology University of BolognaV.le Berti Pichat 540127 BolognaItaly

This study investigates the role of default options in the relationship between trait anxiety,and decision-making styles and financial decisions.One hundred and ninety-four participants were divided into three groups and subjected to three different conditions.Under each experimental condition,they had to decide whether to accept or reject investment proposals.In the first group,they had been enrolled in investment plans by default(opt-out condition),in the second group,they had not been automatically enrolled in these plans(opt-in condition),and in the third group they had to choose whether to enroll or not(control condition).The results showed that the investment decisions of anxious,avoidant,rational and dependent individuals could be facilitated by default options.In conclusion,using default options as a“nudge”can support specific groups of people to improve their financial decisions.

关键词： Nudge Default options Anxiety Decision-making styles Investments

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The Partition of Unity Method for High-Order Finite Volume Schemes Using Radial Basis Functions Reconstruction

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Numerical Mathematics(Theory,Methods and Applications) 2009年第2期2卷 153-179页

作者： Serena Morigi fiorella Sgallari Department of Mathematics University of BolognaP.zza Porta San Donato5BolognaItaly CIRAM University of BolognaVia Saragozza8BolognaItaly

This paper introduces the use of partition of unity method for the development of a high order finite volume discretization scheme on unstructured grids for solving diffusion models based on partial differential equations.The unknown function and its gradient can be accurately reconstructed using high order optimal recovery based on radial basis functions.The methodology proposed is applied to the noise removal problem in functional surfaces and images.Numerical results demonstrate the effectiveness of the new numerical approach and provide experimental order of convergence.

关键词：径向基函数高阶统一方法体积计分割偏微分方程非结构网格扩散模型

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Implicit Shape Reconstruction of Unorganized Points Using PDE-Based Deformable 3D Manifolds

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Numerical Mathematics(Theory,Methods and Applications) 2010年第4期3卷 405-430页

作者： Elena Franchini Serena Morigi fiorella Sgallari Department of Mathematics-CIRAM University of BolognaVia Saragozza 840123 BolognaItaly Department of Mathematics University of BolognaPiazza Porta S.Donato 540126 BolognaItaly

In this work we consider the problem of shape reconstruction from an unorganized data set which has many important applications in medical imaging, scientific computing, reverse engineering and geometric modelling. The reconstructed surface is obtained by continuously deforming an initial surface following the Partial Differential Equation (PDE)-based diffusion model derived by a minimal volume-like variational formulation. The evolution is driven both by the distance from the data set and by the curvature analytically computed by it. The distance function is computed by implicit local interpolants defined in terms of radial basis functions. Space discretization of the PDE model is obtained by finite co-volume schemes and semi-implicit approach is used in time/scale. The use of a level set method for the numerical computation of the surface reconstruction allows us to handle complex geometry and even changing topology,without the need of user-interaction. Numerical examples demonstrate the ability of the proposed method to produce high quality reconstructions. Moreover, we show the effectiveness of the new approach to solve hole filling problems and Boolean operations between different data sets.

关键词： Partial Differential Equation surface reconstruction numerical computation Boolean operations distance function level set method data set complex geometry approach diffusion model effectiveness high quality different problems changing used in medical initial defined PDE

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Prognostic relevance of normocytic anemia in elderly patients affected by cardiovascular disease

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Journal of Geriatric Cardiology 2021年第8期18卷 654-662页

作者： Liana Spazzafumo Fabiola Olivieri Jacopo Sabbatinelli Roberta Galeazzi Rina Recchioni fiorella Marcheselli Paola Tamburrini Roberto Antonicelli Epidemiologic Observatory Regional Health AgencyRegione MarcheAnconaItaly Department of Clinical and Molecular Sciences UniversitàPolitecnica delle MarcheAnconaItaly Center of Clinical Pathology and Innovative Therapy Italian National Research Centre on AgingIRCCS INRCAAnconaItaly SOD Medicina di Laboratorio Azienda Ospedaliero Universitaria Ospedali RiunitiAnconaItaly Clinical Laboratory and Molecular Diagnostic Italian National Research Center on AgingIRCCS INRCAAnconaItaly Department of Cardiology-CCU Italian National Research Centre on AgingIRCCS INRCAAnconaItaly

BACKGROUND Anemia associated with cardiovascular diseases(CVD) is a common condition in older persons. Prevalence and prognostic role of anemia were extensively studied in patients with myocardial infarction(MI) or congestive heart failure(CHF) whereas limited data were available on patients with atrial fibrillation(AF). This study was conducted to assess the clinical prevalence and prognostic relevance of anemia in elderly patients affected by AF and other CVDs.METHODS A total of 866 elderly patients(430 men and 436 women, age: 65-98 years, mean age: 85 ± 10 years) were enrolled.Among these patients, 267 patients had acute non-ST-segment elevation MI(NSTEMI), 176 patients had acute CHF, 194 patients had acute AF and 229 patients were aged-matched healthy persons(CTR). All parameters were measured at the hospital admission and cardiovascular mortality was assessed during twenty-four months of follow-up.RESULTS The prevalence of anemia was higher in NSTEMI, CHF and AF patients compared to CTR subjects(50% vs. 15%, P <0.05), with normocytic anemia being the most prevalent type(90%). Adjusted mortality risk was higher in anemic patient versus non-anemic patient in all the groups of patients [NSTEMI: hazard ratio(HR) = 1.81, 95% CI: 1.06-2.13;CHF: HR = 2.49, 95% CI:1.31-4.75;AF: HR = 1.98, 95% CI: 1.01-3.88]. Decreased hemoglobin levels(P = 0.001) and high reticulocyte index(P = 0.023) were associated with higher mortality in CVD patients.CONCLUSIONS The significant associations between CVD and anemia and the prognostic relevance of anemia for elderly patients with CVD were confirmed in this study. The presence of anemia in AF patients is associated with a two-fold increased mortality risk compared with non-anemic AF patients. Low hemoglobin and high reticulocyte count independently predict mortality in elderly patients with CVD.

关键词： patients anemia cardiovascular

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FISSION1A, an Arabidopsis Tail-Anchored Protein, Is Localized to Three Subcellular Compartments

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Molecular Plant 2014年第8期7卷 1393-1396页

作者： Cristina Ruberti[a],[b],, Alex Costa[c],[d], Emanuela Pedrazzini[e], fiorella Lo Schiavo[a] Michela Zottini[a], [a]Department of Biology University of Padua Via U. Bassi 58/B I-35131 Padua Italy[b] Present address: MSU-DOE Plant Research Laboratory and Department of Plant Biology Michigan State University 612 WilsonRoad East Lansing MI 48824 USA[c]Department of Biosciences University of Milan Via G. Celoria 26 I-20133 Milan Italy[d]Institute of Biophysics National Research Council (CNR) Via G. Celoria 26 I-20133 Milan Italy[e]Institute of Agricultural Biology and Biotechnology National Research Council (CNR) via Bassini 15 I-20133 Milan Italy

Dear Editor, The multiple targeting proteins that have been described in yeast, mammals, and plants have generated intriguing areas of inquiry, including the evolutionary relevance of common proteins shared by different organelles, the mechanisms that determine targeting to each organelle, and, finally, the extent of this phenomenon. Several dual-targeted proteins have been identified in eukaryotic cells.

关键词： MITOCHONDRIA PLANTS CELLS

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Youth and Employment： The Effectiveness of the Youth Guarantee Plan in Emilia Romagna and Sicily

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Journal of Sociology Study 2017年第1期7卷 43-55页

作者： fiorella Vinci University eCampus Italy

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Prognostic value of glycated hemoglobin in colorectal cancer

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World Journal of Gastroenterology 2016年第45期22卷 9984-9993页

作者： Patrizia Ferroni Vincenzo Formica David Della-Morte Jessica Lucchetti Antonella Spila Roberta D'Alessandro Silvia Riondino fiorella Guadagni Mario Roselli San Raffaele Roma Open University 00166 Rome Italy Interinstitutional Multidisciplinary Biobank (Bio BIM) IRCCS San Raffaele Pisana00166 Rome Italy Department of Systems Medicine Medical Oncology UnitTor Vergata Clinical CenterUniversity of Rome Tor Vergata00133 Rome Italy Department of Systems Medicine University of Rome Tor Vergata00133 RomeItaly

AIM To investigate the clinical significance of routinely used glycemic parameters in a cohort of colorectal cancer(CRC) patients.METHODS Pre-treatment fasting blood glucose, insulin, Hb A1 c and homeostasis model of risk assessment(HOMA-IR) were retrospectively evaluated in a case-control study of 224 CRC and 112 control subjects matched for sex, obesity and diabetes frequency and blood lipid profile.Furthermore, the prognostic value of routinely used glycemic parameters towards progression-free(PFS) and overall survival(OS) was prospectively evaluated.RESULTS Fasting blood glucose, insulin, HOMA-IR and HbA 1c(all P < 0.0001) levels were higher in non-diabetic CRC patients compared with obesity-matched controls. All parameters were associated with increased CRC risk at ROC analysis, but no relationship with clinical-pathological variables or survival outcomes was observed for glycemia, insulinemia or HOMA-IR. Conversely, advanced CRC stage(P = 0.018) was an independent predictor of increased Hb A1 c levels, which were also higher in patients who had disease progression compared with those who did not(P = 0.05). Elevated Hb A1 c levels showed a negative prognostic value both in terms of PFS(HR = 1.24) and OS(HR = 1.36) after adjustment for major confounders, which was further confirmed in a subgroup analysis performed after exclusion of diabetic patients.CONCLUSION HbA 1c might have a negative prognostic value in CRC, thus suggesting that glycemic metabolic markers should be carefully monitored in these patients, independently of overt diabetes.

关键词： Colorectal 癌症打 2 糖尿病 Glycated 血红素胰岛素抵抗预示的价值

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Intestinal permeability after Mediterranean diet and low-fat diet in non-alcoholic fatty liver disease

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World Journal of Gastroenterology 2019年第4期25卷 509-520页

作者： Marco Biolato fiorella Manca Giuseppe Marrone Consuelo Cefalo Simona Racco Giacinto A Miggiano Venanzio Valenza Antonio Gasbarrini Luca Miele Antonio Grieco Department of Gastroenterological Endocrine-Metabolic and Nefro-Urological Sciences Fondazione Policlinico Universitario A. Gemelli IRCCS Institute of Special Medical Pathology and Medical Semeiotics Università Cattolica del Sacro Cuore Institute of Internal Medicine and Geriatrics Università Cattolica del Sacro Cuore Department of Image Diagnostics Oncological Radiotherapy and Hematology Sciences Fondazione Policlinico Universitario A. Gemelli IRCCS Nuclear Medicine Institute Università Cattolica del Sacro Cuore

BACKGROUND In non-alcoholic fatty liver disease(NAFLD), a high-fat or high-fructose diet increases intestinal permeability and promotes derangement of the gut-liver axis.We hypothesize that, diet could be able to modulate intestinal permeability in patients with NAFLD.AIM To detect diet-induced modification of intestinal permeability in patients with NAFLD undergoing a Mediterranean diet or a low-fat diet.METHODS The current study was a dietary intervention for non-diabetic, patients with biopsy-verified NAFLD and increased transaminases. A crossover design was employed: participants underwent 16 weeks of Mediterranean diet, 16 wk of free wash-out, and 16 weeks of low-fat diet. Both diets were hypocaloric and no consumption of supplements was allowed. All patients were followed bimonthly by a dietitian. Evaluations of clinical and metabolic parameters were completed at baseline and at the end of each dietary period. Intestinal permeability was assessed by chromium-51 ethylene diamine tetraacetate excretion testing(51 CrEDTA).RESULTS Twenty Caucasian patients, 90% male, median age 43 years, body mass index(BMI) 30.9, with biopsy-verified NAFLD were enrolled. At the end of 16 weeks of a Mediterranean diet, a significant reduction in mean body weight(-5.3 ± 4.1 kg,P = 0.003), mean waist circumference(-7.9 ± 4.9 cm, P = 0.001), and mean transaminase levels [alanine aminotransferase(ALT)-28.3 ± 11.9 IU/L, P =0.0001; aspartate aminotransferase(AST)-6.4 ± 56.3 IU/L, P = 0.01] were observed. These benefits were maintained after 16 wk of wash-out and also after16 wk of low-fat diet, without further improvements. Fourteen of the 20 patients had intestinal permeability alteration at baseline(mean percentage retention of51 Cr-EDTA = 5.4%), but no significant changes in intestinal permeability were observed at the end of the 16 wk of the Mediterranean diet or 16 wk of the low-fat diet.CONCLUSION Mediterranean diet is an effective strategy for treating overweight, visceral obesity and serum transaminase in patients with NAFLD.

关键词： Liver steatosis Gut-liver axis Nutrition Personalized medicine Visceral obesity

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