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Proton pump inhibitors and dysbiosis: Current knowledge and aspects to be clarified

World Journal of Gastroenterology 2019年第22期25卷 2706-2719页

作者： Giovanni Bruno Piera Zaccari giulia rocco giulia Scalese Cristina Panetta Barbara Porowska Stefano Pontone Carola Severi Department of Internal Medicine and Medical Specialties Gastroenterology UnitSapienza University of RomeRome 00161Italy Department of Surgical Sciences Sapienza University of RomeRome 00161Italy Department of Cardio-Thoracic Vascular Surgery and TransplantsSapienza University of RomeRome 00161Italy

Proton pump inhibitors (PPIs) are common medications within the practice of gastroenterology. These drugs, which act through the irreversible inhibition of the hydrogen/potassium pump (H+/K+-ATPase pump) in the gastric parietal cells, are used in the treatment of several acid-related disorders. PPIs are generally well tolerated but, through the long-term reduction of gastric acid secretion, can increase the risk of an imbalance in gut microbiota composition (i.e., dysbiosis). The gut microbiota is a complex ecosystem in which microbes coexist and interact with the human host. Indeed, the resident gut bacteria are needed for multiple vital functions, such as nutrient and drug metabolism, the production of energy, defense against pathogens, the modulation of the immune system and support of the integrity of the gut mucosal barrier. The bacteria are collected in communities that vary in density and composition within each segment of the gastrointestinal (GI) tract. Therefore, every change in the gut ecosystem has been connected to an increased susceptibility or exacerbation of various GI disorders. The aim of this review is to summarize the recently available data on PPI-related microbiota alterations in each segment of the GI tract and to analyze the possible involvement of PPIs in the pathogenesis of several specific GI diseases.

关键词： Proton pump inhibitors Hypochloridria Gut microbiota Dysbiosis Gastrointestinal tract Cancer Helicobacter pylori Gastrointestinal infections

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Application of ultrasonography-elastography score to suspect porto-sinusoidal vascular disease in patients with portal vein thrombosis

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Hepatobiliary & Pancreatic Diseases International 2024年第1期23卷 20-24页

作者： Stefania Gioia Adriano De Santis giulia d’Amati Silvia Nardelli Alessandra Spagnoli Arianna Di rocco Lorenzo Ridola Oliviero Riggio Department of Translational and Precision Medicine Sapienza University of RomeRomeItaly Department of Radiological Oncologicaland Pathological SciencesSapienza University of RomeRomeItaly Department of Public Health and Infectious Diseases Sapienza University of RomeRomeItaly

Background:Porto-sinusoidal vascular disease(PSVD)and portal vein thrombosis(PVT)are causes of portal hypertension characterized respectively by an intrahepatic and a pre-hepatic obstacle to the flow in the portal *** PVT may be a consequence of PSVD,in PVT patients at presentation,a pre-existing PSVD should be *** these patients the identification of an underlying PSVD would have relevant implication regarding follow-up and therapeutic management,but it could be *** this setting ultrasonography may be valuable in differential *** aim of the study was to use ultrasonography to identify parameters to discriminate between PSVD and“pure”PVT and then to suspect PVT secondary to a pre-existing ***:Fifty-three patients with histologically proven PSVD and forty-eight patients affected by chronic PVT were enrolled and submitted to abdominal ultrasonography with elastography by acoustic radiation force impulse(ARFI).Results:ARFI was higher and superior mesenteric vein(SMV)diameter was wider in PSVD patients than in PVT ***,a prognostic score was obtained as linear combinations of the two parameters with a good discrimination capacity between PSVD and PVT(the area under the curve=0.780;95%confidence interval:0.690-0.869).Conclusions:A score based on ARFI and SMV diameter may be useful to suspect an underlying PSVD in patients with PVT and to identify a subgroup of patients to be submitted to liver biopsy.

关键词： Non-cirrhotic portal hypertension Porto-sinusoidal vascular disease Chronic portal vein thrombosis Liver stiffness Portal hypertension Acoustic radiation force impulse

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Hemiarthroplasty for irreparable distal radius fractures in the elderly:A comprehensive review

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World Journal of Orthopedics 2024年第6期15卷 578-584页

作者： Adriano Cannella Ludovico Caruso giulia Maria Sassara Giuseppe Taccardo Marco Passiatore Marina Marescalchi rocco De Vitis Department of Orthopaedics Fondazione Policlinico Universitario A Gemelli IRCCSRome 00168Italy Department of Bone and Joint Surgery ASST-Spedali CiviliBrescia 25123Italy

BACKGROUND Elderly patients maintaining functional independence can now be candidates for primary wrist hemiarthroplasty to manage acute irreparable distal radius fractures(DRFs).However,further investigation with long-term follow-up is required to validate these initial *** To review the literature on the outcomes of distal radius hemiarthroplasty with available implants to assess its viability as a treatment *** A comprehensive review of the literature was conducted using electronic databases,including PubMed,Medline,and *** search terms employed were"distal radius fracture","hemiarthroplasty","wrist arthroplasty",and related *** search was restricted to articles published in English from 1980 until June *** criteria encompassed cases or case series of DRF treated with hemiarthroplasty,providing clinical or radiographic outcomes,and published in peer-reviewed *** A total of 2508 articles from PubMed and 883 from Scopus were identified *** screening and removal of duplicates,13 articles met the inclusion *** articles,predominantly clinical retrospective studies,provided insights into hemiarthroplasty outcomes,including functional improvements and *** was a treatment option for complex DRF,particularly those cases with severe comminution,intraarticular involvement,or severe *** outcomes demonstrated improvements in pain relief,wrist mobility,and grip strength,with variability across *** included implant loosening,infection,nerve injury,and stiffness,with varying incidence rates influenced by surgical techniques and implant ***-term outcomes were inadequately documented,warranting further *** Hemiarthroplasty is a promising treatment for irreparable DRF in the ***-term outcomes and complications require further study.

关键词： Irreparable distal radius fracture Hemiarthroplasty Osteoporosis Wrist prosthesis Elderly

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Long-term assessment of collagenase treatment for Dupuytren’s contracture:A 10-year follow-up study

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World Journal of Orthopedics 2024年第4期15卷 355-362页

作者： Marco Passiatore Vitale Cilli Adriano Cannella Ludovico Caruso giulia Maria Sassara Giuseppe Taccardo rocco De Vitis Department of Bone and Joint Surgery ASST-Spedali CiviliBrescia 25123Italy Department of Chirurgie de la Main Centre Hospitalier Interregional Edith CavellBruxelles 1160Belgium Department of Orthopedics Fondazione Policlinico Universitario Agostino Gemelli IRCSSRome 00168Italy

BACKGROUND Enzymatic fasciotomy with collagenase clostridium histolyticum(CCH)has revolutionized the treatment for Dupuytren’s contracture(DC).Despite its benefits,the long-term outcomes remain *** study presented a comprehensive 10-year follow-up assessment of the enduring effects of CCH on patients with *** To compare the short-term(12 wk)and long-term(10 years)outcomes on CCH treatment in patients with *** A cohort of 45 patients was treated with CCH at the metacarpophalangeal(MCP)joint and the proximal interphalangeal(PIP)joint and underwent systematic *** study adhered to multicenter trial protocols,and assessments were conducted at 12 wk,7 years,and 10 years *** Thirty-seven patients completed the 10-year *** 10 years,patients treated at the PIP joint exhibited a 100%***,patients treated at the MCP joint only showed a 50%*** satisfaction varied,with a lower satisfaction reported in PIP joint *** exceeding 20 degrees on the total passive extension deficit was observed,indicating a challenge for sustained *** differences were noted between outcomes at the 7-year and 10-year *** CCH demonstrated sustained efficacy when applied to the MCP ***,caution is warranted for CCH treatment at the PIP joint due to a high level of recurrence and low patient ***-intervention is needed within a decade of treatment.

关键词： Collagenase Xiapex Dupuytren disease Dupuytren recurrence Long term follow-up

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The Pyramidal Lobe of the Thyroid

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Health 2014年第18期6卷 2535-2540页

作者： Gregorio Patrizi Giorgio Di rocco Domenico Giannotti Maria giulia Bernieri Felice Sperandeo Rina Orkabi Paolo Onori Eugenio Gaudio Adriano Redler Department of Surgical Sciences Faculty of Medicine and Dentistry Sapienza University of Rome Rome Italy Department of Radiology Oncology and Pathology Faculty of Medicine and Dentistry Sapienza University of Rome Rome Italy Department of Anatomical Histological Forensic Medicine and Orthopedic Sciences Faculty of Pharmacy and Medicine Sapienza University of Rome Rome Italy

Anatomy of the thyroid has been extensively studied but the presence of pyramidal lobe varies in percentages from 15% to 75% of cases according to different authors. We therefore investigated systematically this peculiar anatomical aspect. From January 2001 to December 2011, 1002 patients underwent total thyroidectomy in our Division of General Surgery. We analyzed the data collected on the latest 200 thyroidectomies: for all patients pyramidal lobe was measured at removal of the specimen then dimension of the pyramidal lobe after fixation was checked. We found the pyramidal lobe in all cases. In most cases, it was approximately 2 cm (range 1 - 8 cm on fresh specimen). At histology it was described in 72% of cases, after fixation size decreased by a third approximatively. This is the first systematic intraoperative study to verify the prevalence of the thyroid pyramidal lobe. In our experience, the pyramidal lobe is always present and the thyroglossal duct is identifiable.

关键词： Thyroid Pyramidal Lobe Thyroidectomy Surgical Anatomy Thyroid Anatomy Thyroid Surgery Neck Anatomy Neck Surgery

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Self-worth and psychological adjustment of obese children:An analysis through the Draw-A-Person

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World Journal of Psychiatry 2016年第3期6卷 329-338页

作者： Giuseppe Scimeca Amelia Alborghetti Antonio Bruno giulia Maria Troili Gianluca Pandolfo Maria Rosaria Anna Muscatello rocco Antonio Zoccali Psychiatric Unit Department of BiomedicalDental Sciences and Morpho-functional ImagingUniversity of Messina "Don Carlo Gnocchi" Foundation

AIM To investigate psychopathological correlates of child obesity via the Draw-A-Person test(DAP).METHODS The participants were 50 children with a mean age of 9.74 *** mass index(BMI) was used as a measure of body *** were divided into normal(n = 17),overweight(n = 14) and obese(n = 19).Two qualitative methods of scoring the DAP based on an integrative approach were used to assess self-concept(ESW) and overall level of children's adjustment(EAC).A procedure for judging interpretative skills of clinicians was implemented before they evaluated children's *** As predicted by our hypothesis,BMI was negatively correlated with ESW,r(50) =-0.29,P < 0.05,but not with EAC,r(50) =-0.08,P = *** evaluate the effect of gender,Pearson correlations were re-computedregrouping the sample accordingly:BMI and EAC reached a significant negative correlation in female subjects,r(24) =-0.36,P < 0.05,and a positive correlation in male subjects,r(26) = 0.37,P = < 0.05;negative correlation between BMI and ESW became stronger in females,r(24) =-0.51,P < 0.01 but not in males,whose correlation disappeared resulting not-significant,r(26) =-0.06,P = *** effect of age was *** indicate that obesity has a negative correlation exclusively on overall adjustment and self-concept in female *** It was concluded that there is a negative bias toward females that reveals how the stigma of obesity is widespread in Western society.

关键词： Obesity Draw a person Draw-A-Person test Projective techniques Psychopathology

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