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Quality of life in rectal cancer surgery:What do the patient ask?

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World Journal of Gastrointestinal Surgery 2015年第12期7卷 349-355页

作者： giovanni D de Palma gaetano Luglio Center of Excellence for Technical Innovation in Surgery Department of Clinical Medicine and SurgeryUniversity of Naples Federico IISchool of Medicine department of Clinical Medicine and Surgery University of Naples Federico IISchool of Medicine

Rectal cancer surgery has dramatically changed with the introduction of the total mesorectal excision(TME), which has demonstrated to significantly reduce the risk of local recurrence. The combination of TME with radiochemotherapy has led to a reduction of local failure to less than 5%. On the other hand, surgery for rectal cancer is also impaired by the potential for a significant loss in quality of life. This is a new challenge surgeons should think about nowadays: If patients live more, they also want to live better. The fight against cancer cannot only be based on survival, recurrence rate and other oncological endpoints. Patients are also asking for a decent quality of life. Rectal cancer is probably a paradigmatic example: Its treatment is often associated with the loss or severe impairment of faecal function, alteration of body anatomy, urogenital problems and, sometimes, intractable pain. The evolution of laparoscopic colorectal surgery in the last decades is an important example, which emphasizes the importance that themes like scar, recovery, pain and quality of life might play for patients. The attention to quality of life from both patients and surgeons led to several surgical innovations in the treatment of rectal cancer: Sphincter saving procedures, reservoir techniques(pouch and coloplasty) to mitigate postoperative faecal disorders, nerve-sparing techniques to reduce the risk for sexual dysfunction. Even more conservative procedures have been proposed alternatively to the abdominal-perineal resection, like the local excisions or transanal endoscopic microsurgery, till the possibility of a wait and see approach in selected cases after radiation therapy.

关键词： Quality of life Rectal cancer Laparoscopicsurgery Sphincter preservation Nerve-sparing

Folate targeted coated SPIONs as efficient tool for MRI

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Nano Research 2017年第9期10卷 3212-3227页

作者： Cinzia Scialabba Roberto Puleio Davide Peddis Gaspare Varvaro Pietro Calandra giovanni Cassata Luca Cicero Mariano Licciardi gaetano Giammona department ofScienze e Tecnologie Biologiche Chimiche e Farmaceutiche (STEBICEF) University of Palermo 90123 Palermo Italy Istituto Zooprofilattico Sperimentale della Sicilia "A. Mirri" Via Gino Marinuzzi 3 90100 Palermo Italy Institute of Structure of Matter National Research Council (CNR) Via Salaria 00015 Monterotondo Scalo (RM) Italy Istituto per Io Studio dei Materiali Nanostrutturati Consiglio Nazionale delle Ricerche Via Solaria kin. 29.300 00015 Monterotondo Stazione (RM) Italy Mediterranean Center for Human Health Advanced Biotechnologies (CHAB) ATeNCenter University of Palermo 90100 Palermo Italy

The development of more sensitive diagnostic tools allowing an early-stage and highly efficient medical imaging of tumors remains a challenge. Magnetic nanoparticles seem to be the contrast agents with the highest potential, if properly constructed. Therefore, in this study, hybrid magnetic nanoarchitectures were developed using a new amphiphilic inulin-based graft copolymer (INU-LAPEG-FA) as coating material for 10-nm spinel iron oxide (magnetite, Fe3O4) superparamagnetic nanoparticles (SPION). Folic acid (FA) covalently linked to the coating copolymer in order to be exposed onto the nanoparticle surface was chosen as the targeting agent because folate receptors are upregulated in many cancer types. Physicochemical characterization and in vitro biocompatibility study was then performed on the prepared magnetic nanoparticles. The improved targeting and imaging properties of the prepared FA-SPIONs were further evaluated in nude mice using 7-Tesla magnetic resonance imaging (MRI). FA-SPIONs exhibited the ability to act as efficient contrast agents in conventional MRI, providing a potential nanoplatform not only for tumor diagnosis but also for cancer treatment, through the delivery of anticancer drug or locoregional magnetic hyperthermia.

关键词： inulin copolymer superparamagnetic spinel iron oxide nanoparticles (SPIONs) magnetic resonance imaging (MRI) folic acid (FA) cancer targeting

A caval homograft for Budd-Chiari syndrome due to inferior vena cava obstruction

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World Journal of Hepatology 2013年第5期5卷 292-295页

作者： Andrea Mancuso Luigi Martinelli Luciano de Carlis Antonio gaetano Rampoldi giovanni Magenta Aldo Cannata Luca Saverio Belli Epatologia e Gastroenterologia Ospedale Niguarda Cà GrandaPiazza Ospedale Maggiore 320162 MilanoItaly Cardiochirurgia Ospedale Niguarda Cà GrandaPiazza Ospedale Maggiore 320162 MilanoItaly Chirurgia Generale e dei Trapianti Ospedale Niguarda Cà GrandaPiazza Ospedale Maggiore 320162 MilanoItaly Radiologia Interventistica Ospedale Niguarda Cà GrandaPiazza Ospedale Maggiore 320162 MilanoItaly Cardiologia 3 Ospedale Niguarda Cà GrandaPiazza Ospedale Maggiore 320162 MilanoItaly

Transjugular intrahepatic portosystemic shunt (TIPS) is the standard treatment of Budd-Chiari syndrome (BCS) non responsive to medical therapy. However, patients with inferior vena cava (IVC) obstruction proximal to the atrium do not benefit from TIPS and a surgical approach is mandatory. We report the case of BCS due to intrapericardial IVC obstruction. We describe a novel surgical approach using a fresh caval homograft. An attempt to balloon dilatation of the IVC obstruction was complicated by right atrial disruption with tamponade and ventricular fibrillation. Lately, the patient successfully underwent a reconstruction of the cavo-atrial continuity by the interposition of a fresh caval homograft, a novel surgical approach never described before for BCS. Further follow-up revealed progressive reduction and resolution of ascites, and overall clinical improvement. IVC obstruction near to the atrium can be surgically approached with a new technique consisting in inferior vena cava resection and replacement with a caval homograft.

关键词： Budd-Chiari syndrome Inferior vena cava Occlusion Surgery Liver transplantation

New therapeutic perspectives in irritable bowel syndrome: Targeting low-grade inflammation, immuno-neuroendocrine axis, motility, secretion and beyond

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World Journal of Gastroenterology 2017年第36期23卷 6593-6627页

作者： Emanuele Sinagra gaetano Cristian Morreale Ghazaleh Mohammadian Giorgio Fusco Valentina Guarnotta giovanni Tomasello Francesco Cappello Francesca Rossi Georgios Amvrosiadis Dario Raimondo Gastroenterology and Endoscopy Unit Fondazione Istituto Giuseppe GiglioContrada Pietra Pollastra Pisciotto Euro-Mediterranean Institute of Science and Technology department of Experimental Biomedicine and Clinical Neuroscience Section of Human AnatomyUniversity of Palermo Unit of Gastroenterology Ospedali Riuniti Villa Sofia-Vincenzo Cervello department of Medicine Division of Gastroenterology and HepatologyKarolinska InstitutetKarolinska University Hospital Unit of Internal Medicine Ospedali Riuniti Villa Sofia-Vincenzo Cervello Section of Cardio-Respiratory and Endocrine-Metabolic Diseases Biomedical Department of Internal and Specialist MedicineUniversity of Palermo

Irritable bowel syndrome(IBS)is a chronic,recurring,and remitting functional disorder of the gastrointestinal tract characterized by abdominal pain,distention,and changes in bowel *** there are several drugs for IBS,effective and approved treatments for one or more of the symptoms for various IBS subtypes are *** understanding of pathophysiological mechanisms such as the role of impaired bile acid metabolism,neurohormonal regulation,immune dysfunction,the epithelial barrier and the secretory properties of the gut has led to advancements in the treatment of *** regards to therapies for restoring intestinal permeability,multiple studies with prebiotics and probiotics are ongoing,even if to date their efficacy has been *** parallel,much progress has been made in targeting low-grade inflammation,especially through the introduction of drugs such as mesalazine and rifaximin,even if a better knowledge of the mechanisms underlying the low-grade inflammation in IBS may allow the design of clinical trials that test the efficacy and safety of such *** literature review aims to summarize the findings related to new and investigational therapeutic agents for IBS,most recently developed in preclinical as well as Phase 1 and Phase 2clinical studies.

关键词： Therapy Low grade inflammation Motility Secretion Irritable bowel syndrome Immunoendocrine axis

Preventing species invasion:A role for integrative taxonomy?

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Integrative Zoology 2016年第3期11卷 214-228页

作者： Maria V.MAZZAMUTO Andrea GALIMBERTI Giacomo CREMONESI Benoît PISANU Jean-Louis CHAPUIS Jan STUYCK giovanni AMORI Haijun SU gaetano ALOISE Damiano G.PREATONI Lucas A.WAUTERS Maurizio CASIRAGHI Adriano MARTINOLI Environment Analysis and Management Unit-Guido Tosi Research Group Department of Theoretical and Applied SciencesUniversity of InsubriaVareseItaly ZooPlantLab Department of Biotechnoly and BiosciencesUniversity of Milano-BicoccaMilanItaly department of Biology and Biotechnology“Charles Darwin ”SapienzaRome UniversityRomeItaly Centre of Ecology and Conservation Sciences Sorbonne UniversityMNHNCNRSUPMCNational Museum of Natural HistoryParisFrance Research Institute for Nature and Forestry GeraardsbergenBelgium CNR-Institute of Ecosystem Studies Department of Biology and Biotechnology“Charles Darwin”SapienzaRome UniversityRomeItaly Forestry College Guizhou UniversityGuiyangGuizhouChina University of Calabria Museum of Natural History of Calabria and Botanical GardenArcavacata di Rende(CS)Italy

Integrative taxonomy,a multi-disciplinary approach adding modern techniques to traditional morphology-based methods(*** and morphological criteria),can play an important role in bioinvasion research to identify introduced taxa,discover pathways of introduction and inform authorities to control and prevent future *** present study is the first on introduced populations of Callosciurus,Asiatic tree squirrels,known as potentially invasive species in Europe(Italy,Belgium and France).We combined molecular(mitochondrial DNA markers:CoxI,D-loop)and morphometric analysis on skulls,comparing them to the widest morphological and molecular datasets ever assembled for *** collected in Italy and Belgium share the same haplotypes and skull characteristics,but are conspicuously different from the French population in *** data revealed close similarity between French squirrels and Pallas’s squirrels,Callosciurus erythraeus,from Taiwan,*** and Belgian squirrels formed an independent taxonomic lineage in genetic analyses,whose taxonomic rank needs further *** morphological and morphometric characteristics of these 2 populations are,however,similar to known specimens assigned to Callosciurus *** results may indicate a common origin for the populations found in Belgium and *** contrast,French specimens suggest an independent introduction event of squirrels originating from Asia.

关键词： Callosciurus CoxI D-loop invasive species morphometric analysis

Effectiveness of very low-volume preparation for colonoscopy:A prospective, multicenter observational study

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World Journal of Gastroenterology 2020年第16期26卷 1950-1961页

作者： Marcello Maida Emanuele Sinagra gaetano Cristian Morreale Sandro Sferrazza Giuseppe Scalisi Dario Schillaci Marco Ventimiglia Fabio Salvatore Macaluso giovanni Vettori Giuseppe Conoscenti Concetta Di Bartolo Serena Garufi Domenico Catarella Michele Manganaro Clara Maria Virgilio Salvatore Camilleri Gastroenterology and Endoscopy Unit S.Elia-Raimondi HospitalCaltanissetta 93100Italy Gastroenterology and Endoscopy Unit Istituto San Raffaele GiglioCefalu 90015Italy Gastroenterology and Endoscopy Unit Santa Chiara HospitalTrento 38014Italy Gastroenterology Unit ARNAS GaribaldiCatania 95100Italy Gastroenterology Unit Basarocco HospitalNiscemi 93015CaltanissettaItaly department of Internal Medicine Villa Sofia-Cervello HospitalPalermo 90100Italy

BACKGROUND The effectiveness of colonoscopy strictly depends on adequate bowel ***,a 1 L polyethylene glycol plus ascorbate(PEG-ASC)solution(Plenvu;Norgine,Harefield,United Kingdom)has been introduced on the evidence of three phase-3 randomized controlled trials,but it had never been tested in the *** To assess the effectiveness and tolerability of the 1 L preparation compared to 4 L and 2 L-PEG solutions in a real-life *** All patients undergoing a screening or diagnostic colonoscopy after a 4,2 or 1 L PEG preparation,were consecutively enrolled in 5 Italian centers from September 2018 to February *** primary endpoints of the study were the assessment of bowel cleansing success and high-quality cleansing of the right *** secondary endpoints were the evaluation of tolerability,adherence and safety of the different bowel *** cleansing was assessed through the Boston Bowel Preparation *** was defined as consumption of at least 75%of each dose,while tolerability was evaluated through a semiquantitative *** was systematically monitored through adverse events *** Overall,1289 met the inclusion criteria and were enrolled in the *** these,490 patients performed a 4 L-PEG preparation(Selgesse^■),566 a 2 L-PEG cleansing(Moviprep^■or Clensia^■)and 233 a 1 L-PEG preparation(Plenvu^■).Bowel cleansing by Boston Bowel Preparation Scale was 6.5±1.5 overall and 6.3±1.5,6.2±1.5,7.3±1.5(Pdels confirmed 1 L PEG-ASC preparation as an independ

关键词： Colonoscopy Bowel preparation Polyethylene glycol Polyethylene glycolplus ascorbate Effectiveness Tolerability

L-carnitine supplementation improves hematological pattern in patients affected by HCV treated with Peg interferon-α 2b plus ribavirin

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World Journal of Gastroenterology 2011年第39期17卷 4414-4420页

作者： Michele Malaguarnera Marco Vacante Maria Giordano Massimo Motta gaetano Bertino Manuela Pennisi Sergio Neri Mariano Malaguarnera giovanni Li Volti Fabio Galvano department of Biological Chemistry Medical Chemistry and Molecular BiologyUniversity of Catania department of Internal Medicine and Systemic Disease University of Catania Research Center"The Great Senescence" University of Catania

AIM：To evaluate the efficacy of L-carnitine on alleviating anemia,thrombocytopenia and leukopenia,and minimizing dose reductions in patients with chronic hepatitis C virus（HCV）in treatment with Interferonα（IFN-α）plus ***：Sixty-nine patients with chronic hepatitis C were enrolled in the study and divided into two *** A（n=35）received Peg-IFN-α2b plus ribavirin plus L-carnitine,and group B（n=34）received Peg-IFN-αand ribavirin for 12 *** patients underwent laboratory investigations including：red cell count,he-moglobin,white cell count,platelets,bilirubin,alanineaminotransferase（ALT）,aspartate aminotransferase（AST）,and ***：After 12 mo in group A compared to group B we observed significant differences in AST 108.8 vs 76.8（IU/L;P0.001）,ALT *** 112.3（IU/L;P 0.001）,viremia 4.04 vs 2.36（106 copies/mL;P 0.001）,Hb 1 vs 3.5（g/dL;P0.05）,red blood cells 0.3 vs 1.1（1012/L;P0.001）,white blood cells 1.5 vs 3（10/L;P0.001）and platelets 86 vs 85（×10/L;P0.001）.The end treatment responders were 18 vs 12（60%vs 44%）and the non responders were 12 vs 15（40%vs 50%）[odds ratio（OR）1.65,5%CI =0.65-5.37,*** group A compared to group B there was a significant improvement of sustained vi-rological response in 15 vs 7 patients（50%vs25%）,while the relapsers were 3 vs 5（10%vs 18%）（OR 3.57,5%CI=0.65-1.3,P0.001）.CONCLUSION：L-carnitine supplementations modulate erythropoiesis,leucopoiesis and thrombocytopoiesis,and may be useful in patients treated for HCV.L-carni-tine treatment offers the possibility of achieving a sus-tained virological response while preventing overtreat-ment.

关键词： L-carnitine Chronic hepatitis C Anemia In-terferon

Overview of angiogenesis and oxidative stress in cancer

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World Journal of Meta-Analysis 2023年第6期11卷 253-265页

作者： Luigi gaetano Andriolo Vittoria Cammisotto Alessandra Spagnoli Danilo Alunni Fegatelli Michele Chicone gaetano Di Rienzo Vladimiro dell’Anna Giambattista Lobreglio giovanni Serio Pasquale Pignatelli department of General and Specialistic Surgery Paride Stefanini Policlinico Umberto IUniversity of Rome SapienzaRome 06100Italy UnitàOperativa Complessa Chirurgia Toracica Ospedale Vito FazziLecce 73100Italy department of Clinical Internal Anaesthesiological and Cardiovascular SciencesUniversity of Rome SapienzaRome 06100Italy department of Public Health and Infectious Diseases University of Rome SapienzaRome 06100Italy department of Clinical Pathology and Microbiology Ospedale Vito FazziLecce 73100Italy Pathological Anatomy Unit Ospedale Vito FazziLecce 73100Italy

Neoplasms can be considered as a group of aberrant cells that need more vascular supply to fulfill all their ***,they promote angiogenesis through the same neovascularization pathway used *** is a process characterized by a heterogeneous distribution of oxygen caused by the tumor and oxidative stress;the latter being one of the most powerful stimuli of *** a result of altered tumor metabolism due to hypoxia,acidosis *** angiogenic process and oxidative stress can be detected by measuring serum and tissue *** study of the mechanisms underlying angiogenesis and oxidative stress could lead to the identification of new biomarkers,ameliorating the selection of patients with neoplasms and the prediction of their response to possible anti-tumor *** particular,in the treatment of patients with similar clinical tumor phenotypes but different prognoses,the new biomarkers could be ***,they may lead to a better understanding of the mechanisms underlying drug *** studies show that blocking the vascular supply results in antiproliferative activity in vivo in neuroendocrine tumor cells,which require a high vascular supply.

关键词： Neuroendocrine lung tumors Angiogenesis Oxidative stress Neuroendocrine serum markers Neuroendocrine tissue markers Future therapy

Management of antiplatelet or anticoagulant therapy in endoscopy: A review of literature

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World Journal of Gastrointestinal Endoscopy 2020年第6期12卷 172-192页

作者： Marcello Maida Sandro Sferrazza Carlo Maida gaetano Cristian Morreale Alessandro Vitello giovanni Longo Vincenzo Garofalo Emanuele Sinagra Gastroenterology and Endoscopy Unit S.Elia-Raimondi HospitalCaltanissetta 93100Italy Gastroenterology and Endoscopy Unit Santa Chiara HospitalTrento 38123Italy U.O.C di Medicina Interna con Stroke Care Dipartimento di Promozione della SaluteMaterno-Infantiledi Medicina Interna e Specialistica di Eccellenza“G.D’Alessandro”University of PalermoPalermo 93100Italy Cardiology Unit S.Elia-Raimondi HospitalCaltanissetta 93100Italy Gastroenterology and Endoscopy Unit Istituto San Raffaele GiglioCefalu 90015Italy

Endoscopic procedures hold a basal risk of bleeding that depends on the type of procedure and patients’***,they are often performed in patients taking antiplatelet and anticoagulants agents,increasing the potential risk of intraprocedural and delayed *** if the interruption of antithrombotic therapies is undoubtful effective in reducing the risk of bleeding,the thromboembolic risk that follows their suspension should not be ***,it is fundamental for each endoscopist to be aware of the bleeding risk for every procedure,in order to measure the risk-benefit ratio for each ***,knowledge of the proper management of antithrombotic agents before endoscopy,as well as the adequate timing for their resumption is *** review aims to analyze current evidence from literature assessing,for each procedure,the basal risk of bleeding and the risk of bleeding in patients taking antithrombotic therapy,as well as to review the recommendation of American society for gastrointestinal endoscopy,European society of gastrointestinal endoscopy,British society of gastroenterology,Asian pacific association of gastroenterology and Asian pacific society for digestive endoscopy guidelines for the management of antithrombotic agents in urgent and elective endoscopic procedures.

关键词： Antiplatelet Anticoagulant Endoscopy Management Bleeding Risk