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Insulin resistance and steatosis in HBV-HCV co-infected patients: Role of PNPLA3 polymorphisms and impact on liver fibrosis progression

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World Journal of Hepatology 2014年第9期6卷 677-684页

作者： Rosa Zampino Adriana Boemio Aldo Marrone Luciano Restivo maria Chiara Fascione Riccardo Nevola Luigi Elio Adinolfi Nicola Coppola Carmine Minichini Mario Starace Evangelista Sagnelli grazia Cirillo Emanuele Miraglia del Giudice maria Stanzione Emanuele Durante-Mangoni Giovanna Salzillo Department of Medical SurgicalNeurologicalMetabolicand GeriatricSciencesSecond University of Naples80100 NaplesItaly Clinical Hospital of Marcianise ASL Caserta81025 Marcianise (CE)Italy Department of Medical SurgicalNeurologicalMeta-bolicand GeriatricSciencesSecond University of Naples80100 NaplesItaly Department of Mental Health and Public Medicine Section of Infectious DiseasesSecond University of Naples80100 NaplesItaly Department of Pediatrics Second University of Naples80100 NaplesItaly Department of Clinical and Experimental Medicine and Surgery "F. Magrassi e A. Lanzara"Second University of Naples80100 NaplesItaly Internal Medicine Monaldi Hospital Second University of 80100 NaplesItaly

AIM:To evaluate steatosis,insulin resistance(IR)and patatin-like phospholipase domain-containing 3(PNPLA3) and their relation to disease progression in hepatitis B and C viruses(HCV-HBV) coinfected ***:Three hundred and thirty patients with biopsy proven chronic hepatitis were enrolled:66 had HBV-HCV,66 HBV and 198 HCV *** of steatosis,IR and PNPLA3 polymorphisms and their relation to anthropometric,biochemical,virological and histological parameters were ***:Prevalence of steatosis in group HBV-HCV was similar to that in HCV(47.0% vs 49.5%,respec-tively);group HBV showed the lowest steatosis(33.3%).Group HBV-HCV had a lesser degree of steatosis than HCV(P = 0.016),lower HCV RNA levels(P = 0.025) and lower prevalence and degree of IR(P = 0.01).PNPLA3 polymorphisms were associated with *** HBV-HCV showed higher levels of liver fibrosis than group HCV(P = 0.001),but similar to that ob-served in HBV *** HBV-HCV group,liver fibrosis was not associated with steatosis,IR or *** infection was the independent predictor of advanced liver ***:HBV-HCV co-infected patients have lower degree of hepatic steatosis,IR and HCV RNA than HCV mono-infected;co-infected patients showed a more rapid liver fibrosis progression that seems to be due to the double infection and/or HBV dominance.

关键词： Steatosis Insulin resistance Hepatitis B and C viruses co-infection Patatin-like phospholipase domain-containing 3 Liver fibrosis

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Machine learning using the extreme gradient boosting (XGBoost) algorithm predicts 5-day delta of SOFA score at ICU admission in COVID-19 patients

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Journal of Intensive Medicine 2021年第2期1卷 110-116页

作者： Jonathan Montomoli Luca Romeo Sara Moccia Michele Bernardini Lucia Migliorelli Daniele Berardini Abele Donati Andrea Carsetti maria grazia Bocci Pedro David Wendel Garcia Thierry Fumeaux Philippe Guerci Reto Andreas Schüpbach Can Ince Emanuele Frontoni Matthias Peter Hilty RISC-19-ICU Investigators Department of Anaesthesia and Intensive Care Infermi HospitalAUSL della RomagnaRimini 47923Italy Department of Information Engineering UniversitàPolitecnica delle MarcheAncona 60131Italy The BioRobotics Institute and Department of Excellence in Robotics and AI Scuola Superiore Sant’AnnaPisa 56127Italy Anesthesia and Intensive Care Unit Azienda Ospedaliero Universitaria Ospedali RiunitiAncona 60126Italy Department of Biomedical Sciences and Public Health UniversitàPolitecnica delle MarcheAncona 60126Italy Department of Anaesthesia and Intensive Care Fondazione Policlinico Universitario A.Gemelli IRCCSUniversitàCattolica del Sacro CuoreRome 00168Italy Institute of Intensive Care Medicine University Hospital of ZurichZurich 8091Switzerland Swiss Society of Intensive Care Medicine Basel 4001Switzerland Department of Anesthesiology and Critical Care Medicine University Hospital of NancyNancy 54511France Department of Intensive Care Erasmus MC University Medical Center RotterdamRotterdam3015 GDNetherlands 不详

Background:Accurate risk stratification of critically ill patients with coronavirus disease 2019(COVID-19)is essential for optimizing resource allocation,delivering targeted interventions,and maximizing patient survival *** learning(ML)techniques are attracting increased interest for the development of prediction models as they excel in the analysis of complex signals in data-rich environments such as critical ***:We retrieved data on patients with COVID-19 admitted to an intensive care unit(ICU)between March and October 2020 from the RIsk Stratification in COVID-19 patients in the Intensive Care Unit(RISC-19-ICU)*** applied the Extreme Gradient Boosting(XGBoost)algorithm to the data to predict as a binary out-come the increase or decrease in patients’Sequential Organ Failure Assessment(SOFA)score on day 5 after ICU *** model was iteratively cross-validated in different subsets of the study ***:The final study population consisted of 675 *** XGBoost model correctly predicted a decrease in SOFA score in 320/385(83%)critically ill COVID-19 patients,and an increase in the score in 210/290(72%)*** area under the mean receiver operating characteristic curve for XGBoost was significantly higher than that for the logistic regression model(0.86 vs.0.69,P<0.01[paired t-test with 95%confidence interval]).Conclusions:The XGBoost model predicted the change in SOFA score in critically ill COVID-19 patients admitted to the ICU and can guide clinical decision support systems(CDSSs)aimed at optimizing available resources.

关键词： Machine learning Extreme gradient boosting(XGBoost) COVID-19 Multiple organ failure Clinical decision support system(CDSS) Organ dysfunction score

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Clinical significance of glycated hemoglobin in the acute phase of ST elevation myocardial infarction

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World Journal of Cardiology 2014年第4期6卷 140-147页

作者： Chiara Lazzeri Serafina Valente Marco Chiostri maria grazia D'Alfonso Gian Franco Gensini Intensive Cardiac Care Unit Heart and Vessel DepartmentAzienda OspedalieroUniversitaria Careggi

In population-based studies,including diabetic and nondiabetic cohorts,glycated hemoglobin A1c(HbA1c) has been reported as an independent predictor of allcause and cardiovascular disease *** on the prognostic role of HbA1c in patients with acute myocardial infarction(MI) are not univocal since they stem from studies which mainly differ in patients' selection criteria,therapy(thrombolysis vs mechanical revascularization) and number *** present review is focused on available evidence on the prognostic significance of HbA1c measured in the acute phase in patients with ST-elevation myocardial infarction(STEMI) submitted to primary percutaneous coronary intervention(PCI).We furthermore highlighted the role of HbA1c as a screening tool for glucose intolerance in patients with *** to available evidence,in contemporary cohorts of STEMI patients submitted to mechanical revascularization,HbA1c does not seem to be associated with short and long term mortality ***,HbA1c may represent a screening tool for glucose intolerance from the early phase on in STEMI *** a pragmatic ground,an HbA1c testhas several advantages over fasting plasma glucose or an oral glucose tolerance test in an acute *** test can be performed in the non-fasting state and reflects average glucose concentration over the preceding 2-3 *** therefore proposed an algorithm based on pragmatic grounds which could be applied in STEMI patients without known diabetes in order to detect glucose intolerance abnormalities from the early *** main advantage of this algorithm is that it may help in tailoring the follow-up program,by helping in identifying patients at risk for the development of glucose intolerance after *** validation of this algorithm in prospective studies may be required in the contemporary STEMI population to resolve some of these uncertainties around HbA1c screening cutoff points.

关键词： Glycated hemoglobin ST-elevation myocardial infarction Prognosis Hyperglycemia Glucose intolerance

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Echography in brain imaging in intensive care unit: State of the art

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World Journal of Radiology 2014年第9期6卷 636-642页

作者： Anselmo Caricato Sara Pitoni Luca Montini maria grazia Bocci Pina Annetta Massimo Antonelli Department of Anes-thesiology and Intensive Care Medicine Catholic University of the Sacred Heart "A. Gemelli" Teaching Hospital Intensive Care Unit

Transcranial sonography(TCS)is an ultrasound-based imaging technique,which allows the identification of several structures within the brain *** the past it has been applied for bedside assessment of different intracranial pathologies in ***-ently,TCS is also used on adult patients to diagnose intracranial space occupying lesions of various origins,intracranial hemorrhage,hydrocephalus,midline shift and neurodegenerative movement disorders,in both acute and chronic clinical *** comparison with conventional neuroimaging methods(such as com-puted tomography or magnetic resonance),TCS has the advantages of low costs,short investigation times,repeatability,and bedside *** noninva-sive characteristics,together with the possibility of of-fering a continuous patient neuro-monitoring system,determine its applicability in the monitoring of multiple emergency and non-emergency ***,TCS is a still underestimated imaging modality that requires a wider diffusion and a qualified training *** this review we focused on the main indications of TCSfor the assessment of acute neurologic disorders in in-tensive care unit.

关键词： Brain sonography Transcranial sonography Ultrasounds Cerebral sonography Brain imaging Hy-drocephalus Cerebral hemorrhage

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Trend in prevalence of uncontrolled total serum cholesterol for cardio-cerebro-vascular disease in a mediterranean area, 1988/89-2008/09

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World Journal of Cardiology 2013年第11期5卷 420-425页

作者： Vincenzo Capuano Norman Lamaida Ernesto Capuano maria Immacolata Borrelli Rocco Capuano Elisabetta Notari Anna grazia Iannone Federica Marchese Matteo Sonderegger Eduardo Capuano Department of Cardiovascular Diseases University Hospital of Salerno-Mercato S.Severino Hospital Local Health Authority

AIM: To examine trends of uncontrolled total serum cholesterol, treatment and control in a Mediterranean region(Campania). METHODS: We considered and compared the data collected as part of "Montecorvino Rovella Project" 1988-1989 and cross-sectional data from the two phases of the "VIP Project-Valle dell'Irno Prevenzione": 1998-1999(1stphase) and 2008-2009(2ndphase), in the 35-74-year-old-population. RESULTS: Data show a reduction of mean cholesterolemia in the last twenty years of 7.3 mg/dL for men and unchanged values for women. In the three surveys the mean values for serum cholesterol are in men: 205.2 ±47.1 mg/dL(1988/89), 200 ± 38.9 mg/dL(1998/99) and 197.9 ± 40.2 mg/dL(2008/09); in the women: 203.1 ± 42.5 mg/dL(1988/89), 198.9 ± 37.9 mg/dL(1998/99) and 203.3 ± 39.3 mg/dL(2008/09). Prevalence of uncontrolled high cholesterol ≥ 240 mg/dL for men decreased from 20.8%(1988/89) to 14.3%(1998/99) and 13.9%(2008/9), P = 0.002; for women the values decreased from 19.9%(1988/89), to 18.2%(1998/99) and 18.1%(2008/09), P = 0.007. Is statistically increased the number of patients treated and those treated to target. CONCLUSION: Encouraging increases in awareness, treatment, and control of hypercholesterolemia occurred from 1988 through 2008. Nevertheless, control of hypercholesterolemia remains poor.

关键词： Mediterranean diet Hypercholesterolemia Drug Heart disease Southern Italy

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Altered molecular pattern of mucosal healing in Crohn's disease fibrotic stenosis

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World Journal of Gastrointestinal Pathophysiology 2013年第3期4卷 53-58页

作者： Enzo Ierardi Floriana Giorgio Domenico Piscitelli mariabeatrice Principi Santina Cantatore maria grazia Fiore Roberta Rossi Michele Barone Alfredo Di Leo Carmine Panella Gastroenterology Department of Medical and Surgical Sciences University of Foggia 71100 Foggia Italy Gastroenterology Department of Emergency and Organ Transplantation University of Bari 70124 Bari Italy

AIM: To investigate tumor necrosis factor-α (TNF-α), syndecan 1 and basic fibroblast growth factor (bFGF) balance in Crohn's disease (CD) strictures. METHODS: Our study was performed on 24 surgical specimens of CD fibrotic stenosis. Ten histological normal surgical samples were retrieved for both the large and small bowel from patients with benign conditions and healthy tissue represented control collection. Sex and age in controls did not differ from CD group. Three endoscopic biopsy specimens taken after informed consent in subjects with normal colon were also used as negative controls. TNF-α, syndecan 1 and bFGF were detected by both reverse transcriptase reverse transcriptase polymerase chain reaction after mRNA extraction (results expressed as fold-change) and ***: TNF-α did not show any significant difference between CD and control specimens (1.54 ± 1.19; P > 0.05). Very high levels of bFGF were observed in CD (11.76 ± 4.65; P syndecan 1 > TNF-α = control. Immunoreactivity for bFGF was observed in epithelial, stromal, endothelial cells and even in the muscular layer, whilst in normal tissue it was almost unexpressed. Syndecan 1 and TNF-α staining was confined to mucosal epithelial and stromal cells, while in controls syndecan 1 was found in its normal site, i.e. , basolateral area of the crypts and TNF-α very poorly expressed. CONCLUSION: Fibrotic stenosis of CD may be the final result of an irreversible transformation of different cells into fibrogenic phenotype no longer inhibited by posttranscriptional regulation.

关键词： Crohn’s disease Fibrotic stenosis Tumor necrosis factor-α Syndecan 1 Basic fibroblast growth factor

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Comparison of partners-heart failure algorithm vs care alert in remote heart failure management

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World Journal of Cardiology 2015年第12期7卷 922-930页

作者： Leonardo Calo’ Annamaria Martino Claudia Tota Alessandro Fagagnini Renzo Iulianella Marco Rebecchi Luigi Sciarra Giuseppe Giunta maria grazia Romano Roberto Colaceci Antonio Ciccaglioni Fabrizio Ammirati Ermenegildo de Ruvo Division of Cardiology Policlinico Casilino Cardiovascular RespiratoryNephrologic and Geriatrics Sciences DepartmentUmberto I HospitalSapienza University of Rome Department of Cardiology G.B. Grassi Hospital

AIM: To compare the utility of the partners-heart failure(HF) algorithm with the care alert strategy for remote monitoring,in guiding clinical actions oriented to treat impending ***: Consecutive cardiac resynchronizationdefibrillator recipients were followed with biweekly automatic transmissions. After every transmission,patients received a phone contact in order to check their health status,eventually followed by clinical actions,classified as "no-action","non-active" and "active". Active clinical actions were oriented to treat impending HF. The sensitivity,specificity,positive and negative predictive values and diagnostic accuracy of the partners-HF algorithm vs care alert in determining active clinical actions oriented to treat pre-HF status and to prevent an acute decompensation,were also ***: The study population included 70 patients with moderate to advanced systolic HF and QRS duration longer than 120 ms. During a mean follow-up of 8 ± 2 mo,665 transmissions were collected. No deaths or HF hospitalizations occurred. The sensitivity and specificity of the partners-HF algorithm for active clinical actions oriented to treat impending HF were 96.9%(95%CI: 0.96-0.98) and 92.5%(95%CI: 0.90-0.94) respectively. The positive and negative predictive values were 84.6%(95%CI: 0.82-0.87) and 98.6%(95%CI: 0.98-0.99) respectively. The partners-HF algorithm had an accuracy of 93.8%(95%CI: 0.92-0.96) in determining active clinical actions. With regard to active clinical actions,care alert had a sensitivity and specificity of 11.05%(95%CI: 0.09-0.13) and 93.6% respectively(95%CI: 0.92-0.95). The positive predictive value was 42.3%(95%CI: 0.38-0.46); the negative predictive value was 71.1%(95%CI: 0.68-0.74). Care alert had an accuracy of 68.9%(95%CI: 0.65-0.72) in determining active clinical ***: The partners-HF algorithm proved higher accuracy and sensitivity than care alert in determining active clinical actions oriented to treat impendin

关键词： Heart failure Cardiac resynchronization therapy Defibrillators Remote monitoring

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HER2-based recombinant immunogen to target DCs through FcγRs for cancer immunotherapy

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世界最新医学信息文摘 2015年第5期 7-7页

作者： Ilaria grazia Zizzari Filippo Veglia Federica Taurino Hassan Rahimi Elena Quaglino Francesca Belleudi Federica Riccardo Morena Antonilli Chiara Napoletano Filippo Bellati Pierluigi Benedetti-Panici maria Rosaria Torrisi Luigi Frati marianna Nuti Aurelia Rughetti

Dendritic cell(DC)-based immunotherapy is an attractive approach to induce long lasting antitumor effector cells aiming to control cancer progression. DC targeting is a critical step in the design of DC vaccines in order to optimize delivery and processing of the antigen, and several receptors have been characterized for this purpose. In this study, we employed the FcγRs to target DCs both in vitro and in vivo. We designed a recombinant molecule(HER2- Fc) composed of the immunogenic sequence of the human tumor-associated antigen HER2(aa 364–391) and the Fc domain of a human Ig G1. In a mouse model, HER2-Fc c DNA vaccination activated significant T cell-mediated immune responses towards HER2 peptide epitopes as detected by IFN-γ ELIspot and induced longer tumor latency as compared to Ctrl-Fc-vaccinated control mice. Human in vitro studies indicated that the recombinant HER2-Fc immunogen efficiently targeted human DCs through the FcγRs resulting in protein cross-processing and in the activation of autologous HER2-specific CD8+ T cells from breast cancer patients.

关键词： Dendritic cells Cancer immunotherapy HER2 Antigen processing FcγR Dendritic cell targeting

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蕈样肉芽肿和Sézary综合征分类和分期的修订方案——国际皮肤淋巴瘤学会和欧洲癌症研究治疗特别工作组的建议(续完)

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白血病·淋巴瘤 2009年第1期18卷 48-50+63页

作者： Elise Olsen Eric Vonderheid Nicola Pimpinelli Rein Willemze Youn Kim Robert Knobler Herschel Zackheim Madeleine Duvic Teresa Estrach Stanford Lamberg Gary Wood Reinhard Dummer Annamari Ranki Gunter Burg Peter Heald Mark Pittelkow maria-grazia Bernengo Wolfram Sterry Liliane Laroche Franz Trautinger Sean Whittaker 张培红陈辉树 Department of Medicine Divisions of Dermatology and OncologyDuke University Medical Center Department of Dermatology Johns Hopkins University Department of Dermatological Sciences University of Florence Department of Dermatology Leiden University Medical Center Department of Dermatology Stanford University Medical Center Department of Dermatology University of Vienna Department of Dermatology University of Californiaat Department of Dermatology University of Texasat Department of Dermatology University of Barcelona Department of Dermatology University of Wisconsin Department of Dermatology University Hospital Zurich Department of Dermatology and Venereal Diseases Helsinki University Hospital Department of Dermatology Yale University Department of Dermatology Mayo Clinic Department of Dermatology University of Turin Department of Dermatology Charit éHumboldt University Department of Immuno-Dermatology Hospital Avicenne-University of Paris ⅩⅢ Department of Dermstology University of Vienna St John's Institute of Dermatology Skin Tumour UnitSt Thomas'Hospital

4淋巴结N分类的修订4.1外周淋巴结肿大的界定很久就意识到淋巴结肿大对MF患者生存具有负面影响。在MFCG分类中,"N"只代表外周淋巴结。虽然对肿大的淋巴结大小还没有相应的定义,但是在所有患者(甚至无可触及淋巴结肿大的患者)中将淋巴结... 详细信息

4淋巴结N分类的修订4.1外周淋巴结肿大的界定很久就意识到淋巴结肿大对MF患者生存具有负面影响。在MFCG分类中,"N"只代表外周淋巴结。虽然对肿大的淋巴结大小还没有相应的定义,但是在所有患者(甚至无可触及淋巴结肿大的患者)中将淋巴结活检作为评价分期的一个项目已不是问题,因为每个N级别分期是基于临床和病理组织学特点评估的。Sansville等报道对28例无淋巴

关键词：蕈样肉芽肿综合分类分期修订方案皮肤淋巴瘤学会欧洲癌症治疗工作组淋巴结肿大外周淋巴结病理组织学患者淋巴结活检淋巴结大小特点评估淋巴结炎临床

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蕈样肉芽肿和Sezary综合征分类和分期的修订方案——国际皮肤淋巴瘤学会和欧洲癌症研究治疗特别工作组的建议（待续）

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白血病．淋巴瘤 2008年第6期17卷 466-468页

作者： Elise Olsen Eric Vonderheld Nieola Pimpinelli Rein Willemze Youn Kim Robert Knobler Herschel Zackheim Madeleine Duvic Teresa Estraeh Stanford Lamberg Gary Wood Reinhard Dummer Annamari Ranki Gunter Burg Peter Heald Mark Pittelkow maria-grazia Bernengo Wolfram Sterry Liliane Laroche Franz Trautinger Sean Whittaker 张培红(译) 陈辉树(审校) Department of Medicine Divisions of Dermatology and Oncology Duke University Medical Center Durham NC Department of Dermatology Johns Hopkins University Baltimore MD Department of Dermatological Sciences University of Florence Florence haly Department of Dermatology Leiden University Medical CenterLeiden The Netherlands Department of Dermatology Stanford University Medical Center Stanford CA Department of Dermatology University of Vienna Vienna Austria Department of Dermatology University of Californiaat San Francisco Department of Dermatology University of Texasat Houston Department of Dermatology University of Barcelona Barcelona Spain Department of Dermatology. University of Wisconsin Madison Department of Dermatology University Hospital Zurich Zurich Switzerland Department of Dermatology and Venereal Diseases Helsinki University Hospital Helsinki Finland Department of Dermatology Yale University New Haven CT Department of Dermatology Mayo CLinic Rochester MN Department of Dermatology University of Turin Turin Italy Department of Dermatology Charit e Humboldt University Berlin Germany Department of fmmuno-Dermatology Hospital Avicenne-University of Paris XIII Paris France St John's Institute of Dermatology Skin Tumour Unit St Thomas' Hospital London United Kingdom 不详

ISCL／EORTC推荐蕈样肉芽肿协作组使用皮肤T细胞淋巴瘤（Cutaneous T-cell lymphoma，CTCL）分类及分期修订方案。这个修订方案吸收了自1979年最初的指南发表以来的有关蕈样肉芽肿（Mycosis Fungoides，MF）和Sezary综合征（Sezary synd... 详细信息

ISCL／EORTC推荐蕈样肉芽肿协作组使用皮肤T细胞淋巴瘤（Cutaneous T-cell lymphoma，CTCL）分类及分期修订方案。这个修订方案吸收了自1979年最初的指南发表以来的有关蕈样肉芽肿（Mycosis Fungoides，MF）和Sezary综合征（Sezary syndrome，SS）肿瘤细胞生物学和诊断技术的进展，明确目前影响研究机构和调查者之间有效交流和（或）MF及SS标准化临床实验发展的某些指标，而且为追踪其他有潜在预后意义的指标提供了一个平台。此外，鉴于皮肤淋巴瘤中非MF／非SS亚型预后和临床特点的差异，本方案是特别针对MF和SS的。除了对本修订方案的评估和分期程序做出推荐外，该文还对修订方案的论据做了讨论。

关键词： Sezary综合征蕈样肉芽肿修订方案皮肤淋巴瘤分类工作组皮肤T细胞淋巴瘤 lymphoma

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