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3D additive manufactured composite scaffolds with antibiotic-loaded lamellar fillers for bone infection prevention and tissue regeneration

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Bioactive Materials 2021年第4期6卷 1073-1082页

作者： María C´amara-Torres Stacy Duarte Ravi Sinha Ainhoa Egizabal Noelia´Alvarez Maria Bastianini Michele Sisani paolo Scopece Marco Scatto Alessandro Bonetto Antonio Marcomini Alberto Sanchez Alessandro Patelli Carlos Mota lorenzo Moroni Maastricht University MERLN Institute for Technology-Inspired Regenerative MedicineComplex Tissue Regeneration DepartmentUniversiteitssingel 406229ERMaastrichtthe Netherlands TECNALIA Basque Research and Technology Alliance(BRTA)Mikeletegi Pasealekua 220009Donostia-San SebastianSpain Prolabin&Tefarm S.r.l. Via Dell’Acciaio906134PerugiaItaly d Nadir S.r.l.Via Torino155/b30172VeniceItaly Department of Environmental Sciences Informatics and StatisticsCa’Foscari University of VeniceDorsoduro 324630172VeniceItaly Department of Physics and Astronomy Padova UniversityVia Marzolo835131PadovaItaly

Bone infections following open bone fracture or implant surgery remain a challenge in the orthopedics *** order to avoid high doses of systemic drug administration,optimized local antibiotic release from scaffolds is required.3D additive manufactured(AM)scaffolds made with biodegradable polymers are ideal to support bone healing in non-union scenarios and can be given antimicrobial properties by the incorporation of *** this study,ciprofloxacin and gentamicin intercalated in the interlamellar spaces of magnesium aluminum layered double hydroxides(MgAl)andα-zirconium phosphates(ZrP),respectively,are dispersed within a thermoplastic polymer by melt compounding and subsequently processed via high temperature melt extrusion AM(~190◦C)into 3D *** inorganic fillers enable a sustained antibiotics release through the polymer matrix,controlled by antibiotics counterions exchange or pH ***,both antibiotics retain their functionality after the manufacturing process at high temperatures,as verified by their activity against both Gram+and Gram-bacterial ***,scaffolds loaded with filler-antibiotic do not impair human mesenchymal stromal cells osteogenic differentiation,allowing matrix mineralization and the expression of relevant osteogenic ***,these results suggest the possibility of fabricating dual functionality 3D scaffolds via high temperature melt extrusion for bone regeneration and infection prevention.

关键词： Melt extrusion additive manufacturing Antibiotic delivery Lamellar inorganic fillers Bone infection Bone regeneration Human mesenchymal stromal cells

Performance of liver stiffness measurements by transient elastography in chronic hepatitis

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World Journal of Gastroenterology 2013年第1期19卷 49-56页

作者： Giovanna Ferraioli Carmine Tinelli Barbara Dal Bello Mabel Zicchetti Raffaella Lissandrin Gaetano Filice Carlo Filice Elisabetta Above Giorgio Barbarini Enrico Brunetti Willy Calderon Marta Di Gregorio Roberto Gulminetti paolo Lanzarini Serena Ludovisi Laura Maiocchi Antonello Malfitano Giuseppe Michelone lorenzo Minoli Mario Mondelli Stefano Novati Savino FA Patruno Alessandro Perretti Gianluigi Poma paolo Sacchi Domenico Zanaboni Marco Zaramella Ultrasound Unit Department of Infectious DiseasesFondazione IRCCS Policlinico San MatteoMedical School University of Pavia27100 PaviaItaly Clinical Epidemiology and Biometric Unit Fondazione IRCCS Policlinico San Matteo27100 PaviaItaly Department of Pathology Fondazione IRCCS Policlinico San Matteo27100 PaviaItaly Department of Infectious Diseases Fondazione IRCCS Policlinico San MatteoMedical School University of Pavia27100 PaviaItaly Department of Infectious Diseases Fondazione IRCCS Policlinico San Matteo27100 PaviaItaly

AIM:To compare results of liver stiffness measurements by transient elastography(TE) obtained in our patients population with that used in a recently published ***:This was a single center cross-sectional *** patients with chronic viral hepatitis scheduled for liver biopsy at the outpatient ward of our Infectious Diseases Department were *** was carried out by using FibroScan(Echosens,Paris,France).Liver biopsy was performed on the same day as TE,as day case *** was staged according to the Metavir scoring *** diagnostic performance of TE was assessed by using receiver operating characteristic(ROC) curves and the area under the ROC curve ***:Two hundred and fifty-two patients met the inclusion ***(2%) patients were excluded due to unreliable TE ***,246(171 men and 75 women) patients were *** hundred and ninety-five(79.3%) patients had chronic hepatitis C,41(16.7%) had chronic hepatitis B,and 10(4.0%) were coinfected with human immunodeficiency *** curve analysis identified optimal cut-off value of TE as high as 6.9 kPa forF ≥ 2;7.9 kPa forF ≥ 3;9.6 kPa for F = 4 in all patients(n = 246),and as high as 6.9 kPa for F ≥ 2;7.3 kPa for F ≥ 3;9.3 kPa for F = 4 in patients with hepatitis C(n = 195).Cut-off values of TE obtained by maximizing only the specificity were as high as 6.9 kPa for F ≥ 2;9.6 kPa for F ≥ 3;12.2 kPa for F = 4 in all patients(n = 246),and as high as 7.0 kPa forF ≥ 2;9.3 kPa forF ≥ 3;12.3 kPa forF = 4 in patients with hepatitis C(n = 195).CONCLUSION:The cut-off values of TE obtained in this single center study are comparable to that obtained in a recently published meta-analysis that included up to 40 studies.

关键词： Chronic viral hepatitis Hepatitis C Liver Liver biopsy Liver fibrosis Elastography Transient elastography FibroScan Ultrasound

Complications Following Surgery for Gastric Cancer: Analysis of Prospectively Collected Data

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Journal of Cancer Therapy 2014年第14期5卷 1454-1466页

作者： lorenzo Bruno Lucia Barni Sabrina Pacciani Gaia Masini lorenzo Tofani Federica Tofani Filippo Melli Antonio Taddei Manuela Andonova Miloeva Luca Boni Giancarlo Freschi paolo Bechi Department of Surgery and Translational Medicine University of Florence Florence Italy Clinical Trials Coordinating Center Azienda Ospedaliero-Universitaria Careggi Florence Italy

Background and Aims: The complication rate after surgery for gastric cancer varies according to the particular definition of morbidity, so it’s necessary to report them using a standardized method, the Clavien-Dindo system. The purpose of this study was to prospectively analyze all post-gastrectomy complications in patients with gastric adenocarcinoma according to the severity grade using Clavien-Dindo system, in order to identify risk factors for postoperative complications and their prognostic significance on survival. Methods: This study is based on data from 90 consecutive patients who underwent gastrectomy for gastric neoplasia between January 2010 and February 2014 at the same unit. 15 patients were excluded (benign tumors, GISTs, missing data). Complications were categorized according to the Clavien-Dindo classification (uncomplicated patients vs patients classified ≥Grade I). The following risk factors were studied: age, BMI, sex, operation method, extent of resection, duration of surgery, transfusions, TNM staging, and lymph node ratio. Multivariate logistic regression was used to evaluate the association between risk factors and presence of complications. To assess the effect on overall survival, after selection of covariates using backward elimination, the Cox proportional hazard model was applied. Results: Among these patients, 49 (65.3%) developed complications, stratified as follows: Grade I, 6 (8%);Grade II, 24 (32%);Grade III, 6 (8%);Grade IV, 13 (17.3%). The laparoscopic technique (OR = 0.050;95% CI = 0.005 - 0.550, p = 0.0143) and no transfusions (OR = 0.219;95% CI = 0.058 - 0.827, p = 0.0251) were found to reduce the incidence of postoperative complications in the multivariate analysis. With regard to the survival analysis, lymph node ratio, malnutrition, extended resection and presence of complications were significant predictors of reduced survival in the multivariate analysis. Conclusions: Some variables can predict the risk of postoperative co

关键词： Gastric Cancer Complications Clavien-Dindo Classification Survival Probability

A New Early Gastric Cancer after Subtotal Gastric Resection for Early Cancer: Case Report and Review of the Literature

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Journal of Cancer Therapy 2014年第14期5卷 1450-1453页

作者： lorenzo Bruno Lucia Barni Gabriella Nesi Sabrina Pacciani Gaia Masini Filippo Melli Gherardo Maltinti Tiku Zalla lorenzo Dioscoridi Antonio Taddei Giancarlo Freschi paolo Bechi Department of Surgery and Translational Medicine University of Florence Florence Italy Division of Pathological Anatomy Department of Surgery and Translational Medicine University of Florence Florence Italy

Although the prognosis of early gastric cancer (EGC) is considered to be satisfactory, some patients experience tumor relapse after curative surgery. Both pathogenesis and risk factors of recurrence remain unclear. We describe a case report of a 49-year-old male who underwent subtotal gastric resection D2A for angular gastric cancer. Histological examination revealed gastric adenocarcinoma with low grade of differentiation and colloid areas, intramucosal, and absence of neoplastic proliferation in the surgical margins, in omental stroma and in the six examined lymph nodes (pT1, pN0). 11 years later, the same patient underwent D2 total gastrectomy for gastric cancer in the remnant stomach. New histological examination revealed again gastric adenocarcinoma, intramucosal, medium degree of differentiation, no documentable neoplastic proliferation within the limits of surgical resection, in the thirty-three examined lymph nodes and in the omentum (pT1, pN0).

关键词： Early Gastric Cancer Remnant Gastric Cancer Long Term Follow-Up

Irritable bowel syndrome and chronic constipation: Fact and fiction

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World Journal of Gastroenterology 2015年第40期21卷 11362-11370页

作者： Massimo Bellini Dario Gambaccini paolo Usai-Satta Nicola De Bortoli lorenzo Bertani Santino Marchi Cristina Stasi Gastrointestinal Unit Department of GastroenterologyUniversity of Pisa Gastrointestinal Unit P. Brotzu Hospital Department of Experimental and Clinical Medicine University of Florence Epidemiological Observatory Regional Health Agency of Tuscany

Irritable bowel syndrome(IBS) and functional constipation(FC) are the most common functional gastrointestinal disorders. According to the Rome ⅢCriteria these two disorders should be theoretically separated mainly by the presence of abdominal pain or discomfort relieved by defecation(typical of IBS) and they should be mutually exclusive. However,many gastroenterologists have serious doubts as regards a clear separation. Both IBS-C and FC,often associated with many other functional digestive and non digestive disorders,are responsible for a low quality of life. The impact of the media on patients' perception of these topics is sometimes disruptive,often suggesting a distorted view of pathophysiology,diagnosis and therapy. These messages frequently overlap with previous subjective opinions and are further processed on the basis of the different culture and the previous experience of the constipated patients,often producing odd,useless or even dangerous behaviors. The aim of this review was to analyze the most common patients' beliefs about IBS-C and CC,helping physicians to understand where they should focus their attention when communicating with patients,detecting false opinions and misconceptions and correcting them on the basis of scientific evidence.

关键词： Irritable bowel syndrome Chronic constipation Func

Congenital analbuminemia in a patient affected by hypercholesterolemia:A case report

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World Journal of Clinical Cases 2019年第4期7卷 466-472页

作者： Patrizia Suppressa Concetta Carbonara Francesca Lugani Monica Campagnoli Teresa Troiano lorenzo Minchiotti Carlo Sabbà Department of Internal Medicine and Rare Disease Centre University Hospital of Bari Department of Medicine University of Bari School of Medicine Laboratory of Molecular Nephrology Istituto Giannini Gaslini Department of Molecular Medicine University of Pavia Department of Clinical Pathology University Hospital of Bari Department of Interdisciplinary Medicine Geriatric Unit and Rare Disease Center "Aldo Moro" University

BACKGROUND Congenital analbuminemia(CAA) is a very rare disorder. Our data describes the clinical features and laboratory results of a new case established by mutation analysis of the albumin gene in a 39-year-old woman presenting with hypercholesterolemia. Our findings contribute to shed light on the molecular genetics of the disorder and confirm that safe and well tolerated hypocholesterolemic treatment with atorvastatin may be administered in dislipidemic patient with CAA in order to reduce their cardiovascular *** SUMMARY Our patient presented with a history of hypercholesterolemia and referred asthenia and heaviness in both legs. She was born from healthy and nonconsanguineous parents and her development was normal. She had not familiarity for early cardiovascular disease, and did not report personal history of hypertension, chronic kidney or liver diseases. Clinical laboratories results showed critically reduced value of albumin whereas other serum proteins were elevated. Main causes of hypoalbuminemia(proteinuria, inflammatory state and insufficient hepatic synthesis) were ruled out by normal procedures and laboratory tests. So the hypothesis of a CAA was tested through mutation analysis of the albumin gene that revealed a homozygous CA deletion in exon 12,at nucleotide positions c1614-1615. This finding brought to the diagnosis of *** the patient receives Atorvastatin 20 mg od and undergoes clinical and laboratory follow-up every six months. She never needed albumin *** Our experience shows how treatment with atorvastatin may be safely administered and well tolerated in patients affected by CAA.

关键词： Congenital analbuminemia Hypercholesterolemia Hypoalbuminemia Rare disease Case report

Temporal Trends in Radiation Dose Associated with Coronary Computed Tomography Angiography

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Open Journal of Radiology 2014年第1期4卷 101-110页

作者： paolo Marraccini Alessandro Mazzarisi Clara Carpeggiani Mathis Schluter Marco Brambilla Massimiliano Bianchi lorenzo Faggioni Giuseppe Coppini Carlo Bartolozzi Eugenio Picano Clinical Institute of Physiology CNR Pisa Italy CNR Tuscany Region G Monasterio Foundation Pisa Italy Department of Radiology Pisa University Pisa Italy Health Physics Unit Ospedale Maggiore Novara Italy

Background: In 2010, the International Atomic Energy Agency launched the “3A’s campaign” as an effective tool for primary cancer prevention. In 2011, the American Association of Physicists in Medicine recommended the size specific dose estimate (SSDE). Objectives: To audit doses of Coronary CT Angiography (Coronary CTA) in tertiary care referral center. Methods: We reviewed 998 consecutive Coronary CTA (from 2007 to 2012). Doses (CTDIvol mGy), DLP (mGy*cm), effective dose (DLP*0.014, mSv) were on-line archived. SSDE was estimated retrospectively. Appropriateness score was evaluated for exams performed from the 2010. Results: Overall median dose per Coronary CTA was 49.7 mGy for CTDIvol, 55.5 mGy for SSDE, 994.96 mGy*cm for DLP, 13.9 mSv for effective dose. Median DLP decreased over time (1452.94 in 2007, 1605.56 in 2008, 1113.49 in 2009, 759.99 in 2010, 448.61 in 2011 and 497.88 mGy*cm in 2012, p 1 (88%) CTDIvol underestimated SSDE (48.49 vs 57.19 mGy), whilst in patients with SDF < 1 (12%) CTDIvol overestimated SSDE (56.46 vs 50.3 mGy). Scans were appropriate in 58%, uncertain in 24%, and inappropriate in 18% of cases. Doses were similar in appropriate, uncertain or inappropriate examinations and in excellent-to-good (81%) vs. sufficient-to-poor (19%) image quality exams. Conclusions: Coronary CTA reference doses can be very misleading. SSDE can allow individual technique optimization. The dose is similar in appropriate and inappropriate examinations, and unrelated to image quality. The rate of inappropriate examinations is still too high even after dissemination of guidelines.

关键词： Ischemic Heart Disease X Ray Cardiac Computed Tomography Cardiovascular Imaging Radiation Dosing

Emergent and delayed hybrid external fixation management of tibial pilon fractures: A multicentric retrospective analysis of 80 patients

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Journal of Acute Disease 2017年第4期6卷 169-174页

作者： Giuseppe Rollo Marco Filipponi paolo Pichierri Valentina Russi lorenzo Nalbone Michele D'Arienzo Sara Cavalera Gianfranco Corina Michele Bisaccia Luigi Meccariello Departement of Orthopedics and Traumatology Vito Fazzi HospitalLecceItaly Orthopaedics and Traumatology Clinic the University of Palermo Hospital'Paolo Giaccone'PalermoItaly Departement of Orthopedics and Traumatology University Hospital"Policlinico di Modena"ModenaItaly Departement of Orthopedics and Traumatology Di Summa-Perrino HospitalBrindisiItaly Division of Orthopedics and Trauma Surgery University of PerugiaS.Maria della Misericordia HospitalPerugiaItaly

Objective:To report our experience with the hybrid external fixator in ***:We assessed 80 cases of pilon fracture treated with the external fixator during the period of January 2009 and December 2016:55 men (69%) and 30 women (33%) with a mean age of 40 years (range between 16 and 70 ). About 45 occurred as isolated trauma, 35 instead were politrauma. Each patient underwent standard radiographic examination and a CT examination. There were 28 open fractures (35%), (Gustilo type 1, 2 and 3) while closed fractures showed soft tissue involvement of various grade (2-3 Tscherne classification). In all cases, the external fixation, sometimes associated with other reduction and synthesis techniques, was used. The timing of surgery was dictated by the condition of the soft tissues. For clinical evaluation, the Mazur score with mean follow-ups at 12 months was ***:The final range of ankle motion was 15 dorsal and 10 plantar flexion. In about 80 cases there was an average Mazur score of83. The mean score was 90;in open fractures 85 to 72. Radiographic healing of fractures in 60 patients occurred in 120 days (mean 105 days), at the time when the external fixator was ***:Pilon fractures are complex and often present complications;the definitive treatment, in emergency or delayed, with hybrid external fixator permits a stable synthesis with minimal soft tissue damage. Weight bearing maybe allowed early and functional recovery is generally good.

关键词： Tibial Pilon External fixation Hybrid external fixation Outcomes Open fracture Soft tissue Injury

Cardiovascular disease risk factor profiles in children with celiac disease on gluten-free diets

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World Journal of Gastroenterology 2013年第34期19卷 5658-5664页

作者： lorenzo Norsa Raanan Shamir Noam Zevit Elvira Verduci Corina Hartman Diana Ghisleni Enrica Riva Marcello Giovannini Department of Pediatrics San Paolo Hospital University of Milan Institute of Gastroenterology Nutrition and Liver DiseasesSchneider Children’s Medical Center of Israel Sackler Faculty of Medicine Tel-Aviv University Marcello Giovannini Università degli Studi di Milano

AIM:To describe the cardiovascular disease(CVD)risk factors in a population of children with celiac disease(CD)on a gluten-free diet(GFD).METHODS:This cross-sectional multicenter study was performed at Schneider Children’s Medical Center of Israel(Petach Tiqva,Israel),and San paolo Hospital(Milan,Italy).We enrolled 114 CD children in serologic remission,who were on a GFD for at least one *** enrollment,anthropometric measurements,blood lipids and glucose were assessed,and compared to values at *** homeostasis model assessment-estimated insulin resistance was calculated as a measure of insulin ***:Three or more concomitant CVD risk factors[body mass index,waist circumference,low density lipoprotein(LDL)cholesterol,triglycerides,blood pressure and insulin resistance]were identified in 14%of CD subjects on a *** most common CVD risk factors were high fasting triglycerides(34.8%),elevated blood pressure(29.4%),and high concentrations of calculated LDL cholesterol(24.1%).On a GFD,four children(3.5%)had insulin *** insulin and HOMA-IR were significantly higher in the Italian cohort compared to the Israeli cohort(P<0.001).Children on a GFD had an increased prevalence of borderline LDL cholesterol(24%)when compared to values(10%)at diagnosis(P=0.090).Trends towards increases in overweight(from 8.8%to 11.5%)and obesity(from 5.3%to 8.8%)were seen on a ***:This report of insulin resistance and CVD risk factors in celiac children highlights the importance of CVD screening,and the need for dietary counseling targeting CVD prevention.

关键词： Celiac disease Cardiovascular disease risk factors Gluten-free diet Insulin resistance Children Hyperlipidemia Cholesterol