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Kidney transplantation from donors with hepatitis C infection

World Journal of Gastroenterology 2014年第11期20卷 2801-2809页

作者： Massimiliano Veroux Daniela Corona Nunziata Sinagra Alessia Giaquinta Domenico Zerbo Burcin Ekser giuseppe giuffrida Pietro Caglià Riccardo Gula Vincenzo Ardita Pierfrancesco Veroux Vascular Surgery and Organ Transplant Unit Department of SurgeryTransplantation and Advanced TechnologiesUniversity Hospital of Catania95123 CataniaItaly

The increasing demand for organ donors to supply the increasing number of patients on kidney waiting lists has led to most transplant centers developing protocols that allow safe utilization from donors with special clinical situations which previously were regarded as contraindications. Deceased donors with previous hepatitis C infection may represent a safe resource to expand the donor pool. When allocated to serology-matched recipients, kidney transplantation from donors with hepatitis C may result in an excellent short-term outcome and a significant reduction of time on the waiting list. Special care must be dedicated to the pre-transplant evaluation of potential candidates, particularly with regard to liver functionality and evidence of liver histological damage, such as cirrhosis, that could be a contraindication to transplantation. Pre-transplant antiviral therapy could be useful to reduce the viral load and to improve the long-term results, which may be affected by the progression of liver disease in the recipients. An accurate selection of both donor and recipient is mandatory to achieve a satisfactory long-term outcome.

关键词： Kidney transplantation Deceased donor Hepatitis C virus De novo glomerulonephritis Liver failure Graft survival End-stage renal disease Hemodialysis

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Focal neurological deficit in acute anemia: Case reports and review of the literature

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World Journal of Neuroscience 2013年第2期3卷 53-56页

作者： Salvatore giuffrida giuseppe Carpinteri Daniela Modica Manuela Pennisi Alfio Catalano Rita Bella Giovanni Pennisi Carolin Cornelius giuseppe Lanza Department “G. F. Ingrassia” Section of Neurosciences University of Catania Catania Italy Department of Chemistry School of Medicine University of Catania Catania Italy Medicina e Chirurgia d’Accettazione d’Urgenza “Policlinico–Vittorio Emanuele” University Hospital Catania Italy

Introduction: Although anemia is not regarded as an usual vascular risk factor for stroke, it is one of the potential mechanism by which the brain does not receive adequate oxygenation. Moreover, the relationship between drop of hemoglobin and acute focal neurological deficits is not clear. We report two patients with cerebral infarction due to acute anemia. Case Reports: Case 1 was a 73-year-old man who complained an episode of loss of consciousness followed by right hemiparesis and dysarthria after few hours. The day after admission he presented melena caused by a duodenal ulcer bleeding. The hemoglobin dropped from 11.3 g/dl to5.6 g/dl in 24 hours. Areas of acute infarctions were evident at diffusion-weighted imaging (DWI) of the brain. Case 2 was a 77-year-old man with a transient episode of aphasia, right lower limb paresis and mental confusion twelve hours after an intervention of PTA and stenting of the left internal carotid artery. Hemoglobin was11.8 g/dl before intervention and9 g/dl 48 hours later. DWI showed bilateral and widespread acute infarcts. Conclusion: Anemia has to be considered as a potential factor in determining or worsening cerebral infarction, especially in patients with carotid or intracranial stenosis, high cerebrovascular lesions load or insufficient collateral supply. Acute or severe anemia may negatively impact the cerebral blood flow and decrease oxygen-carrying capacity, promote rapid deterioration of ischemic penumbra. Brain DWI and treatment of the underlying etiology of acute anemia are crucial in early identification and recovery of cerebral infarctions.

关键词： Low Hemoglobin Level Focal Neurological Sign Brain Diffusion-Weighted Imaging Cerebral Hemodynamic Cerebral Infarction

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Course of Atypical Manifestations of a Case of Charcot-Marie-Tooth Disease over 35 Years of Clinical Observation

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Neuroscience & Medicine 2013年第3期4卷 145-149页

作者： giuseppe Lanza Luisa Vinciguerra Valentina Puglisi Daniela Modica Alfio Catalano giuseppe Zelante Riccardo Ricceri Lorenzo Lupo Salvatore giuffrida Manuela Pennisi Department “G. F. Ingrassia” MED 01 University of Catania Catania Italy Department “G. F. Ingrassia” Section of Neurosciences University of Catania Catania Italy Department of Chemistry University of Catania Catania Italy.

Introduction: Atypical manifestations of peripheral neuropathy are not rare, challenging the differential diagnosis. In the past, the diagnosis of hereditary neuropathy was mainly based on the clinical and electromyographic (EMG) findings and, occasionally, biopsy. Nowadays, the genetic tests allow us to identify more than 40 different genes/loci associated with Charcot-Marie-Tooth (CMT) disease, although some subtypes are clinically indistinguishable. We have followed a patient with a clinical diagnosis of apparent sporadic and atypical CMT and recently diagnosed genetically as distal hereditary motor neuropathy, type V (dHMN-V). Case Report: Thirty-five years ago, a 16 years old patient complained muscular weakness and wasting at the hands small muscles. Sporadic fasciculations were observed whereas deep tendon reflexes and sensation were normal. EMG examination revealed neurogenic muscular denervation in the distribution of C7, C8 and T1 segments bilaterally. Muscular biopsy of the left Biceps Brachii showed rare atrophic fibers and some cellular atypia. The disease has undergone a clinical and EMG progression and diffusion over the years, involving the lower limbs and leading to a bilateral steppage. A more slight diffuse axonal motor neuropathy was also identified in the proband’s son and second cousin. The genetic study found a known missense mutation in BSCL2 gene related to a dHMN-V. Interestingly, there was a remarkable intra-familiar phenotypic variability, especially in the clinical onset and severity. Discussion: Atypical manifestations of hereditary neuropathies often overlap with other conditions. The present case highlights how a comprehensive clinical evaluation and a careful follow-up have led to a correct diagnosis even 35 years later and have allowed to identify other affected family members. The apparent lack of familiarity was probably due to the very soft presentation in the proband’s relatives. Although the genetic study was not available at t

关键词： Hereditary Neuropathies Clinical Overlap Genetic Analysis Phenotypic Variability

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From advanced diagnosis to advanced resection in early neoplastic colorectal lesions:Never-ending and trending topics in the 2020s

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World Journal of Gastrointestinal Surgery 2022年第7期14卷 632-655页

作者： Francesco Auriemma Sandro Sferrazza Mario Bianchetti Maria Flavia Savarese Laura Lamonaca Danilo Paduano Nicole Piazza Enrica giuffrida Lupe Sanchez Mete Alessandra Tucci Sebastian Manuel Milluzzo Chiara Iannelli Alessandro Repici Benedetto Mangiavillano Gastrointestinal Endoscopy Unit Humanitas Mater DominiCastellanza 21053Italy Gastroenterology and Endoscopy Unit Santa Chiara HospitalTrento 38014Italy Digestive Endoscopy Unit San Giuseppe Hospital-MultimedicaMilan 20123Italy Department of Gastroenterology and Gastrointestinal Endoscopy General HospitalSanremo 18038Italy Gastroenterology Unit IRCCS Policlinico San DonatoSan Donato MilaneseDepartment of Biomedical Sciences for HealthUniversity of MilanMilan 20122Italy Gastroenterology and Hepatology Unit A.O.U.Policlinico"G.Giaccone"Palermo 90127Italy Department of Gastroenterology and Digestive Endoscopy IRCCS Regina Elena National Cancer InstituteRome 00144Italy Department of Gastroenterology Molinette HospitalCittàdella salute e della Scienza di TorinoTurin 10126Italy Digestive Endoscopy Unit and Gastroenterology Fondazione PoliambulanzaBrescia 25100Italy Department of Health Sciences Magna Graecia UniversityCatanzaro 88100Italy Digestive Endoscopy Unit and Gastroenterology Humanitas Clinical and Research Center and Humanitas UniversityRozzano 20089Italy Biomedical Science HunimedPieve Emanuele 20090Italy Gastrointestinal Endoscopy Unit Humanitas Mater DominiCastellanzaVarese 21053Italy

Colonoscopy represents the most widespread and effective tool for the prevention and treatment of early stage preneoplastic and neoplastic lesions in the panorama of cancer *** the world there are different approaches to the topic of colorectal cancer prevention and screening:different starting ages(45-50 years);different initial screening tools such as fecal occult blood with immunohistochemical or immune-enzymatic tests;recto-sigmoidoscopy;and *** key aspects of this scenario are composed of a proper bowel preparation that ensures a valid diagnostic examination,experienced endoscopist in detection of preneoplastic and early neoplastic lesions and open-minded to upcoming artificial intelligence-aided examination,knowledge in the field of resection of these lesions(from cold-snaring,through endoscopic mucosal resection and endoscopic submucosal dissection,up to advanced tools),and management of complications.

关键词： Colorectal lesions Colorectal tumor Endoscopic submucosal dissection Endoscopic mucosal resection Cold-endoscopic mucosal resection FTRD® Complications Adverse events Polypectomy

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