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Hepatitis C virus recurrence after liver transplantation:A 10-year evaluation

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World Journal of Gastroenterology 2015年第13期21卷 3912-3920页

作者： Stefano Gitto luca saverio belli Ranka Vukotic Stefania Lorenzini Aldo Airoldi Arrigo Francesco Giuseppe Cicero Marcello Vangeli Lucia Brodosi Arianna Martello Panno Roberto Di Donato Matteo Cescon Gian luca Grazi Luciano De Carlis Antonio Daniele Pinna Mauro Bernardi Pietro Andreone Department of Medical and Surgical Sciences University of Bologna and Azienda Ospedaliero-Universitaria di BolognaPoliclinico Sant’Orsola Malpighi40138 BolognaItaly Department of Gastroenterology Azienda Ospedaliero-Universitaria and University of Modena and Reggio Emilia41124 ModenaItaly Department of Hepatology and Gastroenterology Niguarda Hospital20162 MilanItaly Hepatobiliopancreatic and General Surgery Unit Regina Elena Institute00186 RomeItaly Department of General Surgery and Transplantation Niguarda Hospital20162 MilanItaly

AIM: To evaluate the predictors of 10-year survival of patients with hepatitis C recurrence. METHODS: Data from 358 patients transplanted between 1989 and 2010 in two Italian transplant centers and with evidence of hepatitis C recurrence were analyzed. A χ2, Fisher's exact test and Kruskal Wallis' test were used for categorical and continuous variables, respectively. Survival analysis was performed at 10 years after transplant using the Kaplan-Meier method, and a log-rank test was used to compare groups. A P level less than 0.05 was considered significant for all tests. Multivariate analysis of the predictive role of different variables on 10-year survival was performed by a stepwise Cox logistic ***: The ten-year survival of the entire population was 61.2%. Five groups of patients were identified according to the virological response or lack of a response to antiviral treatment and, among those who were not treated, according to the clinical status(mild hepatitis C recurrence, "too sick to be treated" and patients with comorbidities contraindicating the treatment). While the 10-year survival of treated and untreated patients was not different(59.1% vs 64.7%, P = 0.192), patients with a sustained virological response had a higher 10-year survival rate than both the "non-responders"(84.7% vs 39.8%, P < 0.0001) and too sick to be treated(84.7% vs 0%, P < 0.0001). Sustained virological responders had a survival rate comparable to patients untreated with mild recurrence(84.7% vs 89.3%). A sustained virological response and young donor age were independent predictors of 10-year survival. CONCLUSION: Sustained virological response significantly increased long-term survival. Awaiting the interferon-free regimen global availability, antiviral treatment might be questionable in selected subjects with mild hepatitis C recurrence.

关键词： Hepatitis C Liver transplantation Hepatitis C viru

Trauma-induced“Macklin effect”with pneumothorax and large pneumomediastinum,disguised by allergy

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Frontiers of Medicine 2013年第3期7卷 386-388页

作者： Salomone Di saverio Kenji Kawamukai Andrea Biscardi Silvia Villani luca Zucchini Gregorio Tugnoli Departments of Emergency and Surgery Emergency Surgery and Trauma Surgery UnitTrauma CenterMaggiore Hospital-Bologna Local Health DistrictBolognaItaly Department of Thoracic Surgery Trauma CenterMaggiore HospitalBolognaItaly Accident and Emergency Trauma CenterMaggiore HospitalBolognaItaly

A 56-year-old man presented spontaneously to the Emergency Department complaining of facial and neck oedema after assumption of nonsteroidal anti-inflammatory drugs(NSAIDS).The triage nurse assigned the patient to Accident&Emergency(A&E)doctor as probable allergic reaction to *** X-ray(CXR),ordered after 24 hours,revealed a huge subcutaneous chest and neck emphysema without clearly visible *** chest CT scan showed a small left pneumothorax and a large amount of air in the *** patient was conservatively treated since he was eupnoeic and hemodynamically *** pathophysiology of pneumomediastinum was first described by Macklin in *** Macklin effect involves alveolar ruptures with air dissection along bronchovascular sheaths to the *** this case the patient did not report in his history a recent blunt thoracic trauma and the initial suspicion of an allergic reaction has prevented physicians to immediately achieve the correct diagnosis.

关键词： thoracic trauma differential diagnosis critical care pneumothorax pneumomediastinum CT scan pitfalls lung and airways physiology

Short and long-term outcomes of laparoscopic colectomy in obese patients

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World Journal of Gastroenterology 2013年第42期19卷 7405-7411页

作者： Andrea Vignali Paola De Nardi luca Ghirardelli saverio Di Palo Carlo Staudacher Department of Surgery San Raffaele Scientific InstituteUniversity Vita Salute20132 MilanItaly

AIM:To investigate the impact of laparoscopic colectomy on short and long-term outcomes in obese patients with colorectal ***:A total of 98 obese(body mass index>30kg/m2)patients who underwent laparoscopic(LPS)right or left colectomy over a 10 year period were identified from a prospective institutionally approved database and manually matched to obese patients who underwent open *** were selected to match for body mass index,site of primary disease,American Society of Anesthesiologists score,and year of surgery(±3 year).The parameters analyzed included age,gender,comorbid conditions,American Society of Anaesthesiologists class,diagnosis,procedure,and duration of operation,operative blood loss,and amount of homologous blood *** rate,intra and postoperative complications as were as reoperation rate,30 d and long-term morbidity rate were also *** continuous variables,the Student’s t test was used for normally distributed data the Mann-Whitney U test for nonnormally distributed *** Pearson’sχ2tests,or the Fisher exact test as appropriate,were used for ***:Conversion to open surgery was necessary in 13 of 98 patients(13.3%).In the LPS group,operative time was 29 min longer and blood loss was 78 mL lower when compared to open colectomy(P=0.03,P=0.0001,respectively).Overall morbidity,anastomotic leak and readmission rate did not significantly differ between the two groups.A trend toward a reduction of wound complications was observed in the LPS when compared to open group(P=0.09).In the LPS group,an earlier recovery of bowel function(P=0.001)and a shorter length of stay(P=0.03)were *** a median follow-up of 62(range 12-132)mo 23patients in the LPS group and 38 in the open group experienced long-term complications(LPS vs open,P=0.03).Incisional hernia resulted to be the most frequent long-term complication with a significantly higher occurrence in the open group when compared to the lapa

关键词： Obesity Colon cancer Laparoscopy Right colectomy Left colectomy Colorectal disease

Multimodal nonlinear microscopy: A powerful label-free method for supporting standard diagnostics on biological tissues

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Journal of Innovative Optical Health Sciences 2014年第5期7卷 1-16页

作者： Riccardo Cicchi Francesco saverio Pavone National Institute of Optics National Research Council(INO-CNR)Largo E.Fermi6 50125 FlorenceItaly European Laboratory for Nonlinear Spectroscopy(LENS)University of Florence Sesto FiorentinoItaly Department of Physics University of Florence Sesto FiorentinoItaly International Center of Computational Neurophotonics(ICON)Florence Italy

The large use of nonlinear laser scanning microscopy in the past decade paved the way forpot ential clinical application of this imaging *** nonlinear microscopy techniquesoffer promising label-free solutions to improve diagnostic performances on *** particular,the combination of multiple nonlinear imaging techniques in the same microscope allows inte-grating_morphological with functional information in a morpho-functional *** provides a high-resolution label-free alternative to both histological and immunohis-tochemicai examination of tissues and is becoming increasingly popular among the ***,several technical improvements,including automatic scanning andimage analysis,are required before the technique represents a standard diagnostic *** thisreview paper,we highlight the capabilit ies of multimodal nonlinear microscopy for tissue inaging,by providing various examples on colon,arterial and skin *** comparison between images acquired using multimodal nonlinear microscopy and histology shows a good agreement bet ween the two *** results demonstrate that multimodal nonlinear microscopy is apowerful label-free alternative to standard histopathological methods and has the potential tofind a stable place in the clinical setting in the near future.

关键词： Non-linear microscopy tissue imaging.

A General Approach to L(h,k)-Label Interconnection Networks

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Journal of Computer Science & Technology 2008年第4期23卷 652-659页

作者： Tiziana Calamoneri saverio Caminiti Rossella Petreschi Department of Computer Science Sapienza University of Rome

Given two non-negative integers h and k, an L（h, k）-labeling of a graph G = （V, E） is a function from the set V to a set of colors, such that adjacent nodes take colors at distance at least h, and nodes at distance 2 take colors at distance at least k. The aim of the L（h, k）-labeling problem is to minimize the greatest used color. Since the decisional version of this problem is NP-complete, it is important to investigate particular classes of graphs for which the problem can be efficiently solved. It is well known that the most common interconnection topologies, such as Butterfly-like, Beneg, CCC, Trivalent Cayley networks, are all characterized by a similar structure： they have nodes organized as a matrix and connections are divided into layers. So we naturally introduce a new class of graphs, called （l × n）-multistage graphs, containing the most common interconnection topologies, on which we study the L（h, k）-labeling. A general algorithm for L（h, k）-labeling these graphs is presented, and from this method an efficient L（2, 1）-labeling for Butterfly and CCC networks is derived. Finally we describe a possible generalization of our approach.

关键词： multistage interconnection network L(h k)-labeling channel assignment problem

What paradigm shifts occurred in the management of acute diverticulitis during the COVID-19 pandemic?A scoping review

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World Journal of Clinical Cases 2021年第23期9卷 6759-6767页

作者： Gaetano Gallo Monica Ortenzi Ugo Grossi Gian luca Di Tanna Francesco Pata Mario Guerrieri Giuseppe Sammarco Salomone Di saverio Department of Medical and Surgical Sciences University of CatanzaroCatanzaro 88011Italy Department of General and Emergency Surgery Polytechnic University of MarcheAncona 60121Italy 2^(nd)Surgery Unit Regional Hospital TrevisoDISCOGUniversity of PaduaTreviso 31100Italy The George Institute for Global Health University of New South WalesSydney 2050NSWAustralia Department of General Surgery Ospedale Nicola GiannettasioCorigliano-Rossano 87064Italy La Sapienza University Roma 00185Italy Department of General Surgery University of InsubriaUniversity Hospital of VareseVarese 21100Italy

BACKGROUND Acute colonic diverticulitis(ACD)is common in Western countries,with its prevalence increasing throughout the *** a result of the coronavirus disease 2019(COVID-19),elective surgery and in-patients’visits have been cancelled or postponed *** To systematically explore the impact of the pandemic in the management of *** MEDLINE,Embase,Scopus,MedxRiv,and the Cochrane Library databases were searched to 22 December *** which reported on the management of patients with ACD during the COVID-19 pandemic were *** cross sectional studies,outcomes of interest included the number of hospital admission for ACD,as well as key features of disease severity(complicated or not)across two time periods(pre-and during lockdown).RESULTS A total of 69 papers were inspected,and 21 were eligible for *** papers were cross sectional studies from seven world countries;six were case reports;three were qualitative studies,and two review articles.A 56%overall decrease in admissions for ACD was observed during lockdown,peaking 67%in the largest series.A 4%-8%decrease in the rate of uncomplicated diverticulitis was also noted during the lockdown *** initial non-operative management was recommended for complicated diverticulitis,and encouraged to an out-of-hospital *** initial concerns on the use of laparoscopy for Hinchey 3 and 4 patients to avoid aerosolized contamination,societal bodies have progressively mitigated their initial recommendations as actual risks are yet to be *** During the COVID-19 pandemic,fewer patients presented and were diagnosed with *** decline may have likely affected the spectrum of uncomplicated *** outpatient management and follow up for selected cases may unburden healthcare resources in time of crisis.

关键词： COVID-19 SARS-CoV-2 Acute diverticulitis Diverticular disease Hartmann

Prognostic criteria for postoperative mortality in 170 patients undergoing major right hepatectomy

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Hepatobiliary & Pancreatic Diseases International 2012年第5期11卷 507-512页

作者： Filippo Filicori Xavier M Keutgen Matteo Zanello Giorgio Ercolani Salomone Di saverio Federico Sacchetti Antonio Daniele Pinna Gian luca Grazi General Surgery and Transplant Unit Department of General Surgery and Organ TransplantationUniversity of BolognaVia Massarenti 940138 BolognaItaly Department of Surgery New York Presbyterian Hospital Weill Cornell Medical College Department of Surgery New York Presbyterian HospitalWeill Cornell Medical College Department of Emergency Surgery Maggiore HospitalL.go Nigrisoli 240133 BolognaItaly Hepato-Biliary Surgery Unit Istituto Nazionale Tumori Regina ElenaVia Elio Chianesi5300144 RomaItaly

BACKGROUND: Postoperative hepatic failure is a dreadful complication after major hepatectomy and carries high morbidity and mortality rates. In this study, we assessed the accuracy of the 50/50 criteria (bilirubin >2.9 mg/dL and international normalized ratio >1.7 on postoperative day 5) and the Mullen criteria (bilirubin peak >7 mg/dL on postoperative days 1-7) in predicting death from hepatic failure in patients undergoing right hepatectomy only. In addition, we identified prognostic factors linked to intra-hospital morbidity and mortality in these patients. METHODS: One hundred seventy consecutive patients underwent major right hepatectomy at a tertiary medical center from 2000 to 2008. Nineteen (11.2%) patients suffered from liver cirrhosis. Univariate and multivariate analyses were performed to identify predictors of intra-hospital mortality, morbidity and death from hepatic failure. RESULTS: The intra-hospital mortality was 6.5% (11/170). Of the six patients who died from hepatic failure, one was positive for the 50/50 criteria, but all six patients were positive for the Mullen criteria. Multivariate analysis showed that male gender, hepatitis C (HCV), hepatocellular carcinoma, postoperative bilirubin >7 mg/dL and ALT65 years, HCV, reoperation, andrenal failure were significant predictors of overall intra-hospital mortality on multivariate analysis. CONCLUSIONS: The Mullen criteria were more accurate than the 50/50 criteria in predicting death from hepatic failure in patients undergoing right hepatectomy. A bilirubin peak >7 mg/dL in the postoperative period, HCV positivity, hepatocellular carcinoma, and an ALT level <188 U/L on postoperative day 1 were associated with death from hepatic failure in our patient population.

关键词： hepatectomy liver diseases liver failure postoperative complications prothrombin time bilirubin

Awake laparoscopic cholecystectomy:A case report and review of literature

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World Journal of Clinical Cases 2023年第13期11卷 3002-3009页

作者： Chiara Mazzone Maria Sofia Iacopo Sarvà Giorgia Litrico Andrea Maria luca Di Stefano Gaetano La Greca saverio Latteri Dipartimento di Scienze Mediche Chirurgiche e Tecnologie Avanzate"G.F.Ingrassia"Universitàdegli Studi di CataniaCatania 95123Italy

BACKGROUND Laparoscopic cholecystectomy(LC)is one of the most widely practiced surgical procedures in abdominal *** undergo LC during general anaesthesia;however,in recent years,several studies have suggested the ability to perform LC in patients who are *** report a case of awake LC and a literature *** SUMMARY A 69-year-old patient with severe pulmonary disease affected by cholelithiasis was scheduled for LC under regional *** first performed peridural anaesthesia at the T8-T9 level and then spinal anaesthesia at the T12-L1 *** procedure was managed in total comfort for both the patient and the *** intra-abdominal pressure was 8 *** patient remained stable throughout the procedure,and the postoperative course was *** Evidence has warranted the safe use of spinal and epidural anaesthesia,with minimal side effects easily managed with *** anaesthesia in selected patients may provide some advantages over general anaesthesia,such as no airway manipulation,maintenance of spontaneous breathing,effective postoperative analgesia,less nausea and vomiting,and early ***,this technique for LC is not widely used in Europe;this is the first case reported in Italy in the *** anaesthesia is feasible and safe in performing some types of laparoscopic *** studies should be carried out to introduce this type of anaesthesia in routine clinical practice.

关键词： Laparoscopic cholecystectomy Awake surgery Awake laparoscopy Gallstone disease Regional anaesthesia Spinal anesthesia Case report

Adolescent male genitalia dissatisfaction:a surgical perspective

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Asian Journal of Andrology 2022年第2期24卷 176-179页

作者： Nicola Zampieri Ilaria Dando Francesco saverio Camoglio Woman and Child Hospital Pediatric Surgical UnitUniversity of VeronaVerona 37100Italy Department of Neurosciences Biomedicine and Movement SciencesBiochemistry SectionUniversity of VeronaVerona 37100Italy

Genital dissatisfaction is well known in female and *** is known about male adolescents and their genital *** aim of this study was to investigate and report the role of surgery in male adolescents to improve the evaluation of their *** considered all patients treated for external genital pathology in the period of *** and exclusion criteria were *** underwent an evaluation test before and after *** the study period,137 patients were treated,and at the end of the study,98 cases were considered for *** most frequent pathologies were webbed penis and penile curvature.A postoperative score improvement was noted and patients with concealed penis and webbed penis showed a better postoperative *** was considered an important factor associated with a worse preoperative *** of the external genitalia is important in adolescents,and it is an understudied *** may be associated with a worse evaluation of one’s genital and should be clinically considered to avoid related social problems in ***,cosmetic genital surgery should be considered even in male adolescents.

关键词： adolescent esthetic genital dissatisfaction surgery