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Extrahepatic cholestasis associated with paracoccidioidomycosis:Challenges in the differential diagnosis of biliopancreatic neoplasia

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World Journal of Gastrointestinal Oncology 2024年第6期16卷 2531-2540页

作者： Jose Sebastiao dos Santos Vitor de Moura Arrais William Jose Rosseto Ferreira Ricardo Ribeiro Correa Filho mariangela Ottoboni Brunaldi Rafael Kemp Ajith Kumar Sankanrakutty Jorge Elias Junior Fernando Bellissimo-Rodrigues Roberto Martinez Edson Zangiacomi Martinez Jose Celso Ardengh Faculdade de Medicina de Ribeirao Preto da Universidade de Sao Paulo(FMRP-USP) Departamento de Cirurgia e AnatomiaRibeirao Preto 14049-900Sao PauloBrazil Universidade de Sao Paulo Faculdade de Medicina de Ribeirao Preto da Universidade de Sao Paulo(FMRP-USP)Departamento de PatologiaRibeirao Preto 14048900Sao PauloBrazil Universidade de Sao Paulo Faculdade de Medicina de Ribeirao Preto da Universidade de Sao Paulo(FMRP-USP)Departamento de Imagens MédicasHematologia e Oncologia ClínicaRibeirao Preto 14048900Sao PauloBrazil Universidade de Sao Paulo Faculdade de Medicina de Ribeirao Preto da Universidade de Sao Paulo(FMRP-USP)Departamento de Medicina SocialRibeirao Preto 14015-010Sao PauloBrazil Universidade de Sao Paulo Faculdade de Medicina de Ribeirao Preto da Universidade de Sao Paulo(FMRP-USP)Departamento de Clínica MédicaRibeirao Preto 14015-010Sao PauloBrazil Universidade de Sao Paulo Faculdade de Medicina de Ribeirao Preto da Universidade de Sao Paulo(FMRP-USP)Departamento de Cirurgia e AnatomiaRibeirao Preto 14049-900Sao PauloBrazil and Hospital MoriahServico de Endoscopia DigestivaSao Paulo 04084-002Sao PauloBrazil

BACKGROUND Paracoccidioidomycosis(PCM)may involve the hepatic pedicle and peripan creatic lymph nodes,cause damage to the bile duct and manifest,exceptionally,in combination with extrahepatic cholestasis(EHC),making investigation and treatment *** To investigate the management of patients with visceral PCM admitted with *** All patients diagnosed with PCM treated in a public,tertiary teaching hospital between 1982 and 2020 were retrospectively *** also identified with EHC were allocated to two groups according to the treatment approach for the purpose of comparing clinical,laboratory,and imaging findings,resources used for etiological diagnosis,treatment results,and *** analyses were performed using the linear mixed-effects model(random and fixed effects),which was adjusted using the PROC MIXED procedure of the SAS®9.0 software,and Fisher’s exact *** Of 1645 patients diagnosed with PCM,40(2.4%)had *** these,20(50.0%)lived in the rural area and 29(72.5%)were men,with a mean age of 27.1 years(3-65 years).Jaundice as first symptom and weight loss of at least 10 kg were observed in 16 patients(40.0%),and a mass in the head of the pancreas was observed in 8(20.0%).The etiological diagnosis was made by tissue collection during surgery in 4 cases(10.0%)and by endoscopic methods in 3 cases(7.5%).Twenty-seven patients(67.5%)received drug treatment alone(Group 1),whereas 13(32.5%)underwent endoscopic and/or surgical procedures in combination with drug treatment(Group 2).EHC was significantly reduced in both groups(40.7% in Group 1,with a mean time of 3 months;and 38.4% in Group 2,with a mean time of 7.5 months),with no statistically significant difference between *** recurrence rates,associated mainly with treatment nonadherence,were similar in both groups:37% in Group 1 and 15.4% in Group *** mortality rate was 18.5% in Group 1 and 23% in Group 2,with survival estimates of 71.3% and 72.5%,respectively,with

关键词： Cholestasis Jaundice Obstructive Blastomycosis Paracoccidioides Diagnosis Treatment

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Evidence to suggest adoption of water exchange deservesbroader consideration:Its pain alleviating impact occurs in90%of investigators

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World Journal of Gastrointestinal Endoscopy 2016年第2期8卷 113-121页

作者： Sergio Cadoni Mauro Liggi Premysl Falt Stefano Sanna mariangela argiolas Viviana Fanari Paolo Gallittu Donatella Mura Maria L Porcedda Vit Smajstrla Matteo Erriu Felix W Leung Digestive Endoscopy Unit St.Barbara Hospital09016 IglesiasItaly Digestive Diseases Center Vitkovice Hospital703 84 OstravaCzech Republic Digestive Endoscopy Unit N.S.di Bonaria Hospital09037 San Gavino MonrealeItaly Department of Surgical Sciences University of Cagliari09121 CagliariItaly Sepulveda Ambulatory Care Center Veterans Affairs Greater Los Angeles Healthcare SystemNorth HillsCA 91343United States David Geffen School of Medicine University of California at Los AngelesLos AngelesCA 90024United States

AIM: To determine variations in colonoscopy real-time insertion pain among investigators using three different insertion ***: From March 2013 through June 2014, 18-85-year-old diagnostic and 50-70-year-old screening patients were enrolled at each center to on-demand sedation colonoscopy with water exchange(WE), water immersion(WI) and insufflation with air or CO2 for insertion and withdrawal [air or carbon dioxide(AICD)]. Data were aggregated for analysis. Primary outcome: Variations in real-time maximum insertion pain(0 = none, 1-2 = discomfort, 10 = worst).RESULTS: One thousand and ninety-one cases analyzed: WE(n = 371); WI(n = 338); AICD(n = 382). Demographics and indications were comparable. The WE group had the lowest real-time maximum insertion pain score, mean(95%CI): WE 2.8(2.6-3.0), WI 3.8(3.5-4.1) and AICD 4.4(4.1-4.7), P < 0.0005. Ninety percent of the colonoscopists were able to use water exchange to significantly decrease maximum insertion pain scores. One investigator had high insertion pain in all groups, nonetheless WE achieved the lowest real-time maximum insertion pain score. WE had the highest proportions of patients with painless unsedated colonoscopy(vs WI, P = 0.013; vs AICD, P < 0.0005); unsedated colonoscopy with only minor discomfort(vs AICD, P < 0.0005), and completion without sedation(vs AICD, P < 0.0005).CONCLUSION: Aggregate data confirm superiority of WE in lowering colonoscopy real-time maximum insertion pain and need for sedation. Ninety percent of investigators were able to use water exchange to significantly decrease maximum insertion pain scores. Our results suggest that the technique deserves consideration in a broader scale.

关键词： Colonoscopy Painless colonoscopy Waterimmersion Water exchange Colonoscopy pain

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Nucleoredoxin-like 2 metabolic signaling impairs its potential contribution to neurodegenerative diseases

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Neural Regeneration Research 2023年第3期18卷 529-530页

作者： mariangela Corsi Céline Jaillard Thierry Léveillard Sorbonne Université INSERMCNRSInstitut de la VisionParisFrance

Alzheimer’s disease(AD)threatens the foundations of humanity and our *** is a neurological disorder primarily affecting the elderly through memory disorders,cognitive decline,and loss of *** dramatic consequences of this late-onset disease were illustrated sensitively in Michael Haneke’s masterpiece,*** and governments have invested colossal efforts to develop a treatment for this terrible *** and in the past decade the amyloid cascade has dominated the therapeutic research on AD,but the absence of benefit for patients treated with drugs that reduce brain amyloid deposit questions the role ofβ-amyloid as a causative agent(Herrup,2021).The recent approval of aducanumab by the United States Food and Drug Administration,a drug that targetsβ-amyloid,is at the center of a scandal among clinicians and researchers,as it does not provide therapeutic benefits to patients and is listed among the breakdowns of the year 2021 by Science magazine(Voosen et al.,2021).The lack of progress in curing AD and recent therapeutic failures calls for further exploratory research.

关键词： approval consequences listed

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Lack of transcriptional coordination between mitochondrial and nuclear oxidative phosphorylation genes in the presence of two divergent mitochondrial genomes

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Zoological Research 2022年第1期43卷 111-128页

作者： Ran Xu mariangela Iannello Justin CHavird Liliana Milani Fabrizio Ghiselli Department of Biological Geological and Environmental SciencesUniversity of BolognaBolognaBO 40126Italy Department of Integrative Biology The University of Texas at AustinAustinTX 78712USA

In most eukaryotes,oxidative phosphorylation(OXPHOS)is the main energy production process and it involves both mitochondrial and nuclear *** close interaction between the two genomes is critical for the coordinated function of the OXPHOS *** bivalves show doubly uniparental inheritance(DUI)of mitochondria,where two highly divergent mitochondrial genomes,one inherited through eggs(F-type)and the other through sperm(M-type),coexist in the same ***,it remains a puzzle how nuclear OXPHOS genes coordinate with two divergent mitochondrial genomes in DUI *** this study,we compared transcription,polymorphism,and synonymous codon usage in the mitochondrial and nuclear OXPHOS genes of the DUI species Ruditapes philippinarum using sex-and tissue-specific *** and nuclear OXPHOS genes showed different transcription *** co-transcription signal was observed within mitochondrial(separate for F-and M-type)and within nuclear OXPHOS genes but the signal was weak or absent between mitochondrial and nuclear OXPHOS genes,suggesting that the coordination between mitochondrial and nuclear OXPHOS subunits is not achieved ***-Kreitman and frequency-spectrum based tests indicated that M-type OXPHOS genes deviated significantly from neutrality,and that F-type and M-type OXPHOS genes undergo different selection *** usage analysis revealed that mutation bias and translational selection were the major factors affecting the codon usage bias in different OXPHOS genes,nevertheless,translational selection in mitochondrial OXPHOS genes appears to be less efficient than nuclear OXPHOS ***,we speculate that the coordination between OXPHOS genes may involve post-transcriptional/translational regulation.

关键词： Oxidative phosphorylation Doubly uniparental inheritance Co-transcription Polymorphism Codon usage bias Translational selection

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Impact of carrier transport on the performance of QD lasers on silicon:a drift-diffusion approach

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Photonics Research 2020年第8期8卷 1388-1397页

作者： MARCO SALDUTTI ALBERTO TIBALDI FEDERICA CAPPELLUTI mariangela GIOANNINI Department of Electronics and Telecommunications Politecnico di TorinoTurin 10129Italy

The operation of quantum dot lasers epitaxially grown on silicon is investigated through a quantum-corrected Poisson-drift-diffusion *** in-house developed simulation framework completes the traditional rate equation approach,which models the intersubband transitions involved into simultaneous ground-state and excited-state lasing,with a physics-based description of carrier transport and electrostatic *** code is applied to look into some of the most relevant mechanisms affecting the lasing *** analyze the impact of threading dislocations on non-radiative recombination and laser threshold *** demonstrate that asymmetric carrier transport in the barrier explains the ground-state power quenching above the excited-state lasing ***,we study p-type modulation doping and its benefits/*** observation of an optimum doping level,minimizing the ground-state lasing threshold current,stems from the reduction of the electron density,which counteracts the benefits from the expected increase of the hole *** reduction is due to electrostatic effects hindering electron injection.

关键词： lasing transport diffusion

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A long-term annual water balance analysis of the Aracuai River Basin, Brazil

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Journal of Geographical Sciences 2010年第6期20卷 938-946页

作者： LEITE mariangela Garcia Praca FUJACO Maria Augusta Goncalves Federal University of Ouro Preto Geology Department Campos Morro do Cruzeiro 35400-000 Ouro PretoMinas Gerais Brazil

Semi-arid and arid areas exhibit great temporal variability in water availability. In some of these regions, a one- or two-day rainfall is followed by intervening dry periods of variable length. In recent decades, many rivers of the semi-arid portion of the Jequitinhonha Basin have been undergoing a progressive discharge reduction, mainly of their base flow, the Aracuai River is one of them. In order to understand this transformation, a long-term analysis of the annual water balance of the Aracuai River Basin was performed, the results of which are presented herein. Satellite images, hydrometeorological and river discharge data were analyzed; mean and variance tests were conducted to determine temporal homogeneity. Historical pluviometric data analysis shows no corresponding precipitation reduction and temperature undergoes only a slight increase in the same period. On the other hand, evaporation is extremely high, higher than precipitation during most of the year, leaving almost no water for infiltration （aquifer recharge） and runoff. Furthermore, the Aracuai head- waters of its tributaries are now occupied by a monoculture, Eucaliptus sp., used for paper production. Because of the decreased fluvial discharges, its lowlands, usually used for agriculture and pasture, are abandoned and partially eroded.

关键词： river discharge evaporation Jequitinhonha Basin

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Very low calorie ketogenic diet and common rheumatic disorders:A case report

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World Journal of Clinical Cases 2023年第9期11卷 1985-1991页

作者： mariangela Rondanelli Zaira Patelli Clara Gasparri Francesca Mansueto Cinzia Ferraris Mara Nichetti Tariq A Alalwan Ignacio Sajoux Roberto Maugeri Simone Perna Department of Public Health Experimental and Forensic MedicineUnit of Human and Clinical NutritionIRCCS Mondino FoundationPavia 27100Italy Endocrinology and Nutrition Unit Azienda di Servizi alla Persona"Istituto Santa Margherita"University of PaviaPavia 27100Italy Food Education and Sport Nutrition Laboratory Department of Public HealthExperimental and Forensic MedicineUniversity of PaviaPavia 27100Italy Department of Biology College of ScienceUniversity of BahrainSakhir 32038Bahrain Chief Scientific Office Medical Department Pronokal GroupBarcelona 08001Spain Medical Direction PronoKal GroupSavigliano 12038Italy

BACKGROUND The scientific literature provides evidence that nutritional ketosis can be an important support in the treatment of pathologies in which inflammation is present,as recent studies have shown that ketone bodies have anti-inflammatory activity in numerous diseases,including rheumatic *** report the case of a 22-year-old woman with class I obesity and juvenile idiopathic arthritis who started treatment with a very low calorie ketogenic diet(VLCKD).CASE SUMMARY The patient was a 22-year-old woman diagnosed with juvenile idiopathic arthritis at age 4 years and with a body mass index(BMI)of 30.8 kg/m2,waist circumference(WC)80 cm,fat mass(FM)28.1 kg,free FM 45.7 kg,and visceral adipose tissue(VAT)3.5 kg,assessed on bioimpedance *** was treated using a commercial VLCKD weight-loss program(PNK®method);this program provides high-biological-value protein preparations and natural *** protein preparation contains 15 g protein,4 g carbohydrate,3 g fat,and 50 mg omega-3 docosahexaenoic acid,with an energy content of 90–120 *** four months on the program,the BMI was 28.6 kg/m2,WC 73 cm,FM 23.2 kg,free FM 41.9 kg,and VAT 2.9 *** VLCKD enabled the patient to reach her target weight and to reduce her joint pain and *** inflammatory indices also normalized.

关键词： Very low calorie ketogenic diet Inflammation PNK

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Antioxidant dietary approach in treatment of fatty liver: New insights and updates

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World Journal of Gastroenterology 2017年第23期23卷 4146-4157页

作者： Alessandra Ferramosca mariangela Di Giacomo Vincenzo Zara Dipartimento di Scienze e Tecnologie Biologiche ed Ambientali Università del Salento Via Provinciale Lecce-Monteroni

Non-alcoholic fatty liver disease(NAFLD) is a common clinicopathological condition, encompassing a range of conditions caused by lipid deposition within liver cells. To date, no approved drugs are available for the treatment of NAFLD, despite the fact that it represents a serious and growing clinical problem in the Western world. Identification of the molecular mechanisms leading to NAFLD-related fat accumulation, mitochondrial dysfunction and oxidative balance impairment facilitates the development of specific interventions aimed at preventing the progression of hepatic steatosis. In this review, we focus our attention on the role of dysfunctions in mitochondrial bioenergetics in the pathogenesis of fatty liver. Major data from the literature about the mitochondrial targeting of some antioxidant molecules as a potential treatment for hepatic steatosis are described and critically analysed. There is ample evidence of the positive effects of several classes of antioxidants, such as polyphenols(i.e., resveratrol, quercetin, coumestrol, anthocyanins, epigallocatechin gallate and curcumin), carotenoids(i.e., lycopene, astaxanthin and fucoxanthin) and glucosinolates(i.e., glucoraphanin, sulforaphane, sinigrin and allyl-isothiocyanate), on the reversion of fatty liver. Although the mechanism of action is not yet fully elucidated, in some cases an indirect interaction with mitochondrial metabolism is expected. We believe that such knowledge will eventually translate into the development of novel therapeutic approaches for fatty liver.

关键词：肝的脂肪变性脂肪肝 Lipogenesis 线粒体氧化应力

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Treatment of hepatitis B virus infection in children and adolescents

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World Journal of Gastroenterology 2021年第36期27卷 6053-6063页

作者： mariangela Stinco Chiara Rubino Sandra Trapani Giuseppe Indolfi Department of Health Sciences Pediatric SectionMeyer Children’s University HospitalFlorence 50139Italy Department Neurofarba University of Florence and Meyer Children’s University HospitalFlorence 50139Italy

Hepatitis B virus(HBV)infection is one of the main causes of morbidity and mortality *** children acquire the infection perinatally or during early childhood and develop a chronic hepatitis characterized by a high viral replication and a low-inflammation phase of infection,with normal or only slightly raised *** a conservative approach in children is usually recommended,different therapies exist and different therapeutic approaches are *** main goals of antiviral treatment for children with chronic HBV infection are to suppress viral replication and to warn the disease progression to cirrhosis and hepatocellular carcinoma,although these complications are rare in *** United States Food and Drug Administration(USFDA)and European Medicines Agency(EMA)have approved interferon alfa-2b for children aged 1 year and older,pegylated interferon alfa-2a and lamivudine for children aged 3 years and older,entecavir for use in children aged 2 years and older,and adefovir for use in those 12 years of age and *** disoproxil fumarate is approved by EMA for children aged 2 years and older and by USFDA for treatment in children aged 12 years and ***,EMA has approved the use of tenofovir alafenamide for treatment of children aged 12 years and older or for children weighing more than 35 kg independent of *** narrative review will provide the framework for summarizing indications to antiviral therapy in the management of chronic HBV infection in children and adolescents.

关键词： Hepatitis B Children Adolescents Antiviral therapy Tenofovir disoproxil fumarate Entecavir Interferon

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Exotic break-up modes in heavy ion reactions up to Fermi energies

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Nuclear Science and Techniques 2015年第2期26卷 124-130页

作者： Maria Colonna Virgil Baran Stefano Burrello mariangela Di Prima Paolo Napolitani Carmelo Rizzo INFN-Laboratori Nazionali del Sud Via S Sofia 62Catania I-95123Italy NIPNE-HH Bucharest UniversityBucharest 077125Romania IPN CNRS/IN2P3Universite' Paris-Sud 11Orsay cedex 91406France

We discussed recent studies, within the framework of transport theories, on heavy ion reactions between charge asymmetric systems, from low up to Fermi energies. We concentrated on the analysis of ternary breakup events of dynamical origin occurring in semi-central reactions, where the formation of excited systems in various conditions of shape, excitation energy and spin is observed. At beam energies around 20 A Me V, we showed how this fragmentation mode emerges from the combined action of surface(neck) instabilities and angular momentum effects, leading to the observation of three aligned massive fragments in the exit channel. At Fermi energies, a transition towards a prompt emission of small fragments from the neck region with larger relative velocity with respect to projectile and target remnants is observed. We also focus on isospin sensitive observables, aiming at extracting information on the density dependence of the isovector part of the nuclear effective interaction and of the nuclear symmetry energy.

关键词：重离子反应费米能量不对称系统情调有效相互作用激发系统不稳定性分散模式

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