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Radiofrequency ablation for early oesophageal squamous neoplasia:Outcomes form United Kingdom registry

World Journal of Gastroenterology 2013年第36期19卷 6011-6019页

作者： Rehan J Haidry Mohammed A Butt Jason Dunn Matthew Banks Abhinav Gupta Howard Smart Pradeep Bhandari Lesley Ann Smith Robert Willert Grant Fullarton Morris John massimo di pietro Ian Penman Marco Novelli Laurence B Lovat Department of Surgery and Interventional Science National Medical Laser Centre UCL Department Gastroenterology University College Hospital NHS Foundation Trust Department Gastroenterology Guy’s and St Thomas’ Hospitals NHS Trust Institute for Medical Informatics Oslo University Hospital Department Gastroenterology Royal Liverpool University Hospital Merseyside Department Gastroenterology Princess Alexandra Hospital Cosham Department Gastroenterology Bradford Royal Infirmary Bradford Department Gastroenterology Central Manchester University Hospital Department Gastroenterology Glasgow Royal Infirmary Department Gastroenterology Addenbrooke’s Hospital Royal Infirmary Edinburgh

AIM:To report outcomes on patients undergoing radiofrequency ablation(RFA)for early oesophageal squamous neoplasia from a National ***:A Prospective cohort study from 8 tertiary referral centres in the United *** with squamous high grade dysplasia(HGD)and early squamous cell carcinoma(ESCC)confined to the mucosa were *** lesions were removed by endoscopic mucosal resection(EMR)before *** initial RFA treatment,patients were followed up *** flat dysplasia was treated with RFA until complete reversal dysplasia(CR-D)was achieved or progression to invasive Squamous cell cancer defined as infiltration into the submucosa layer or *** main outcome measures were CR-D at 12 mo from start of treatment,long term durability,progression to cancer and adverse ***:Twenty patients with squamous HGD/ESCC completed treatment *** patients(25%)had EMR before starting RFA ***-D was 50%at12 mo with a median of 1 RFA treatment,mean 1.5(range 1-3).Two further patients achieved CR-D with repeat RFA after this *** per cent with CR-D remain dysplasia free at latest biopsy,with median follow up 24 mo(IQR 17-54).Six of 20 patients(30%)progressed to invasive cancer at 1 *** patients(20%)required endoscopic dilatations for symptomatic structuring after *** of these patients have required serial dilatations thereafter for symptomatic dysphagia with a median of 4 dilatations per *** other 2 patients required only a single dilatation to achieve an adequate symptomatic *** patient developed cancer during follow up after end of treatment ***:The role of RFA in these patients re-mains *** our series 50%patients responded at12 *** figures are lower than limited published data.

关键词： Squamous neoplasia Oesophageal cancer Endoscopic mucosal resection High-grade dysplasia Radiofrequency ablation

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Nano albumin bound-paclitaxel in pancreatic cancer: Current evidences and future directions

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World Journal of Gastroenterology 2017年第32期23卷 5875-5886页

作者： Guido Giordano massimo Pancione Nunzio Olivieri pietro Parcesepe Marianna Velocci Tania di Raimo Luigi Coppola Giuseppe Toffoli Mario Rosario D’Andrea Medical Oncology Unit San Filippo Neri Hospital CRO Aviano National Cancer Institute Department of Sciences and Technologies University of Sannio Department of Biochemistry and Molecular Biology II Faculty of PharmacyComplutense University Department of Biology University of Naples Department of Pathology and diagnostics University of Verona Strada Anatomic Pathology Unit San Filippo Neri00135 RomaItaly Experimental and Clinical Pharmacology Unit CRO-National Cancer Institute Via F

Pancreatic cancer(PDAC) is an aggressive and chemoresistant disease, representing the fourth cause of cancer related deaths in western countries. Majority of patients have unresectable, locally advanced or metastatic disease at time of diagnosis and the 5-year survival rate in these conditions is extremely low. For more than a decade gemcitabine has been the cornerstone of metastatic PDAC treatment, although survival benefit was very poor. PDAC cells are surrounded by an intense desmoplastic reaction that may create a barrier to the drugs penetration within the tumor. Recently PDAC stroma has been addressed as a potential therapeutic target. Nano albumin bound(Nab)-paclitaxel is an innovative molecule depleting tumor stroma, through interaction between albumin and secreted protein acidic and rich in cysteine. Addition of nab-paclitaxel to gemcitabine has showed activity and efficacy in metastatic PDAC first-line treatment improving survival and overall response rate vs gemcitabine alone in the MPACT phase Ⅲ study. This combination represents one of the standards of care in advanced PDAC therapy and is suitable to a broader spectrum of patients compared to other schedules. Nab-paclitaxel is under investigation as a backbone of chemotherapy in novel combinations with target agents or immunotherapy in locally advanced or metastatic PDAC. In this article, we provide an updated and critical overview about the role of nab-paclitaxel in PDAC treatment based on the latest advances in preclinical and clinical research. Furthermore, we focus on the use of nab-paclitaxel within the context of metastatic PDAC treatment landscape and we discuss about future implications in the light of current clinical ongoing trials.

关键词： Nano albumin bound-paclitaxel Pancreatic cancer Metastatic disease Gemcitabine Folfirinox

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Arrhythmic Risk in Paediatric Patients Undergoing Surgical Repair for Pulmonary Atresia with Intact Ventricular Septum

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Congenital Heart disease 2021年第1期16卷 85-94页

作者： pietro Paolo Tamborrino Corrado di Mambro Cecilia Marcolin Walter Vignaroli Giulia Cafiero Gianluca Brancaccio Sonia Albanese massimo Stefano Silvetti Adriano Carotti Fabrizio Drago Paediatric Cardiology and Cardiac Arrhythmia Unit Department of Paediatric Cardiology and Cardiac SurgeryBambino GesùChildren’s HospitalIRCCSRomeItaly European Reference Network for Rare and Low Prevalence Complex disease of the Heart Paediatric Cardiac Surgery Unit Department of Paediatric Cardiology and Cardiac SurgeryBambino GesùChildren’s HospitalIRCCSRomeItaly Sport Medicine Unit Department of Paediatric Cardiology and Cardiac SurgeryBambino GesùChildren’s HospitalIRCCSRomeItaly

Introduction:While previous studies only focused on the arrhythmic risk associated with specific correction strategies,this study evaluates this risk in a large cohort of paediatric patients with all phenotypes of PA-IVS after surgical ***:In this single centre observational cohort study,we retrospectively evaluated 165 patients with a diagnosis of PA-IVS and we excluded those with an exclusively percutaneous treatment,patients lost or with insufficient follow-up and those affected by other arrhythmic *** history and clinical outcomes were ***:86 patients were included in the study(54 male[62.8%],mean age 16.4±6.1 years),with median follow-up from definitive repair of 12.8 years(6.4–18.9 years).They underwent three different final repairs:23 patients(26.7%)univentricular palliation,43(50%)biventricular correction,and 20(23.3%)one and a half ventricle *** patients(15%)developed arrhythmia:6 patients(all the subgroups)sinus node disfunction(SND);2(biventricular repair)premature ventricular complexes;2(one and a half ventricle repair)non-sustained ventricular tachycardia;1(biventricular repair)intra-atrial re-entrant tachycardia;1(one and a half ventricle repair)supraventricular tachyarrhythmia;1(biventricular repair)atrial *** patients with SND needed a pacemaker *** Fontan circulation showed an association with SND,while the other two groups heterogeneous types of ***:The low arrhythmic risk is related to surgical repair,it does not appear to be associated with native cardiomyopathy,and it appears to increase with length of follow *** follow-up in specialized centres is necessary to make an early diagnosis and to manage the potential haemodynamic impact at medium-long term.

关键词： Pulmonary atresia with intact ventricular septum arrhythmic risk univentricular palliation Fontan circulation biventricular repair one and a half repair

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Comprehensive lumped parameter and multibody approach for the dynamic simulation of agricultural tractors with tyre–soil interaction

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IET Cyber-Systems and Robotics 2023年第3期5卷 1-23页

作者： massimo Martelli Damiano Chiarabelli Silvia Gessi pietro Marani Emiliano Mucchi Marco Polastri Institute of Sciences and Technologies for Sustainable Energy and Mobility CNR‐STEMSNational Research CouncilFerraraItaly Department of Engineering University of FerraraFerraraItaly

Modern agricultural tractors are complex systems,in which multiple physical(and technological)domains interact to reach a wide set of competing goals,including work operational performance and energy *** complexity translates to the dynamic,multi‐domain simulation models implemented to serve as digital twins,for rapid prototyping and effective pre‐tuning,prior to bench and on‐field ***,a suitable simulation framework should have the capability to focus both on the vehicle as a whole and on individual *** each of the latter,multiple options should be available,with different levels of detail,to properly address the relevant phenomena,depending on the specific focus,for an optimal balance between accuracy and computation *** methodology proposed here by the authors is based on the lumped parameter approach and integrates the models for the following subsystems in a modular context:internal combustion engine,hydromechanical transmission,vehicle body,and tyre–soil *** model is completed by a load cycle module that generates stimulus time histories to reproduce the work load under real operating *** capability is affected by vertical load on the wheels,which is even more relevant if the vehicle is travelling on an uncompacted soil and subject to a variable drawbar pull force as it is when *** vertical load is,in turn,heavily affected by vehicle dynamics,which can be accurately modelled via a full multibody *** presented lumped parameter model is intended as a powerful simulation tool to evaluate tractor performance,both in terms of fuel consumption and traction dynamics,by considering the cascade phenomena from the wheel–ground interaction to the engine,passing through the dynamics of vehicle bodies and their mass *** capabilities and numerical results are presented for the simulation of a realistic ploughing operation.

关键词： agricultural tractor digital twin lumped parameter simulation,multibody powertrain tyre-soil interaction

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Craving variations in patients with substance use disorder and gambling during COVID-19 lockdown:The Italian experience

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World Journal of Clinical Cases 2022年第3期10卷 882-890页

作者： Maria Chiara Alessi Giovanni Martinotti Domenico De Berardis Antonella Sociali Chiara di Natale Gianna Sepede Daniela Pia Rosaria Cheffo Laura Monti pietro Casella Mauro Pettorruso Stefano Sensi massimo di Giannantonio Department of Neuroscience ImagingClinical SciencesUniversity G.d'AnnunzioChieti-Pescara 66100Italy Department of Pharmacy PharmacologyClinical SciencesUniversity of HertfordshireHertfordshire AL109ABUnited Kingdom National Health Care System Mazzini HospitalTeramo 64100Italy Department of Mental Health UOS Psicologia Ospedaliera Fondazione Policlinico Gemelli IRCSSRome 00118Italy Department of Mental Health and Addiction Services ASL Roma 1Rome 00118Italy

BACKGROUND Following the development of the coronavirus disease-2019(COVID-19)pandemic in Italy,a strict lockdown was imposed from March 9 to May 5,*** risks of self-medication through alcohol or psychoactive substance abuse were increased,as well as the tendency to adopt pathological behaviors,such as gambling and internet *** To evaluate the impact of the COVID-19 pandemic and associated containment measures on craving in a group of patients suffering from substance use disorder and/or gambling disorder who were in treatment in outpatient units or in residency programs as *** One hundred and fifty-three patients completed a structured questionnaire evaluating craving and other behaviors using a visual analogue scale(VAS).Forty-one subjects completed a pencil and paper questionnaire during the *** clinician provided an online questionnaire to 112 patients who had virtual assessments due to lockdown *** analyses were performed using Statistica version *** parameters are presented as the mean±SD and qualitative parameters as number and percentage per *** Kolmogorov-Smirnov test was used to check for normality of *** of variance and Duncan post hoc test were employed to analyze differences among subgroup *** associations between variables were measured using Pearson's correlation.A P value of<0.05 was considered *** The variation in craving between the present and the month before showed VASrelated reductions of craving in 57%,increases in 24%,and no significant change in 19%of the *** level of craving was significantly higher(F=4.36;P<0.05)in outpatients(n=97;mean=3.8±3.1)living in their own home during the quarantine compared with inpatients(n=56;mean=2.8±2.8)in residential *** for tetrahydrocannabinol was the greatest(4.94,P<0.001)among various preferred *** The unexpected result of this study may be explaine

关键词： Substance use disorder Addiction COVID-19 Craving Psychopathology

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Editorial on "Role of thermal ablation in the management of colorectal liver metastasis"

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Hepatobiliary Surgery and Nutrition 2020年第1期9卷 62-64页

作者： Antonio Giorgio pietro Gatti massimo De Luca Paolo Matteucci Valentina Giorgio Liver Unit and Interventional Ultrasound Unit Athena Clinical InstitutePiedimonte Matese(CE)Italy Internal Medicine Unit Brindisi General HospitalBrindisiItaly Liver Unit Cardarelli HospitalNaplesItaly Radiation Oncology Unit Campus BiomedicoRomaItaly Fondazione Policlinico A.Gemelli IRCCS Department of Woman and Child Health and Public HealthRomaItaly

The last 30 years have shown the increasing role of Ablation in the treatment of malignant liver tumors. By the introduction of percutaneous ethanol injection (PEI) as first ablation tool for percutaneous treatment of hepatocellular carcinoma (HCC) in cirrhosis that firstly showed very high efficacy (1), several ablation techniques (mainly thermal) have been introduced in clinical practice aimed at destroying primary and secondary hepatic tumors as alternative or substitute tools to surgery. Radiofrequency ablation (RFA) was the first thermal technique that showed a good efficacy to ablate liver metastases (2). Among the secondary liver tumors, colorectal liver metastases (CRLM) represent the unique indication for ablation (2). Unlike HCC in cirrhosis where the role of RFA is well defined as first line therapy for HCC nodules diameterdigm. Liver resection remains the standard of care for CRLM and the indications to ablation remain confined to nonresectable patients (4). The review article by Takahashi and Berber recently published in HBSN wells illustrates the current role of ablation in treatment of CRLM (5).

关键词： colorectal metastasis surgery

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Role of induced pluripotent stem cells in diagnostic cardiology

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World Journal of Stem Cells 2021年第5期13卷 331-341页

作者： Steven B Karch Vittorio Fineschi pietro Francia Matteo Scopetti Martina Padovano Federico Manetti Alessandro Santurro Paola Frati massimo Volpe School of Medicine University of NevadaLas VegasNV 89102United States Department of Anatomical HistologicalForensic and Orthopaedic SciencesSapienza University of RomeRome 00185Italy division of Cardiology Department of Clinical and Molecular MedicineSapienza University of RomeSt.Andrea HospitalVia di Grottarossa103500189 RomeItaly Department SAIMLAL Sapienza University of RomaRome 00185Italy Department of Clinical and Molecular Medicine Sapienza University of RomeRome 00197Italy

Ethical concerns about stem cell-based research have delayed important advances in many areas of medicine,including *** introduction of induced pluripotent stem cells(iPSCs)has supplanted the need to use human stem cells for most purposes,thus eliminating all ethical *** then,many new avenues have been opened in cardiology research,not only in approaches to tissue replacement but also in the design and testing of antiarrhythmic *** methodology has advanced to the point where induced human cardiomyocyte cell lines can now also be obtained from commercial sources or tissue *** studies with readily available iPSCs have generally confirmed that their behavioral characteristics accurately predict the behavior of beating cardiomyocytes in *** a result,iPSCs can provide new ways to study arrhythmias and heart disease in general,accelerating the development of new,more effective antiarrhythmic drugs,clinical diagnoses,and personalized medical *** focus on producing cardiomyocytes that can be used to replace damaged heart tissue has somewhat diverted interest in a host of other *** manuscript is intended to provide non-specialists with a brief introduction and overview of the research carried out in the field of heart rhythm disorders.

关键词： Human induced pluripotent stem cells diagnostic cardiology Heart rhythm disorders Microelectrode array Stem cell research Ethical principles

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3D Non-Fluoroscopic Cryoablation of Right-Sided Accessory Pathways in Children:Monocentric Study and Literature Review

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Congenital Heart disease 2021年第6期16卷 561-572页

作者： Fabrizio Drago Irma Battipaglia pietro Paolo Tamborrino Luigina Porco Camilla Calvieri Mario Salvatore Russo Vincenzo Pazzano Romolo Remoli massimo Stefano Silvetti Pediatric Cardiology and Cardiac Arrhythmias Unit Department of Pediatric Cardiology and Cardiac SurgeryBambino GesùChildren’s HospitalIRCCSRomeItaly

Background:Cryoablation of accessory pathways(APs)is effective and very safe in children,as previously reported by our *** aim of this retrospective study was to evaluate the current efficacy of 3D non-fluoroscopic cryoablation of right sided APs in children,comparing results obtained with the Ensite VelocityTM and the more recent Ensite PrecisionTM 3D mapping *** and Results:From January 2016 to December 2019,102 pediatric patients[mean age 12.5±2.8,62 males(61%of total cohort)]with right APs underwent 3D non-fluoroscopic transcatheter cryoablation at our ***(14.7%)patients had previously undergone catheter *** procedural success rate was 95.1%(n=97).No significant differences were detected in acute success rates achieved with Ensite Velocity^(TM)or Ensite PrecisionTM systems nor between manifest(94%)and concealed APs(100%).No permanent complications *** follow-up(428±286 days,median 396 days[interquartile range 179-713]),19 patients(19.6%)had *** were more frequent for parahissian/anterior APs compared to midseptal/posterior and lateral APs(p=0.043).Recurrences were not related to the Ensite system used.A redo ablation procedure was attempted in 13 cases,11 cryoablation and 2 radiofrequency ablations:the former was successful in 10 cases out of 11(90.9%).Conclusion:3D cryoablation of right-sided APs is associated with a very high acute success rate with limited use of fluoroscopy,resulting in great benefit to the *** rates are not high and patients can be retreated with cryo-energy with higher success rates.

关键词： 3D Mapping accessory pathway children cryoablation pediatric tachyarrhythmias

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Heart-touching Chilaiditi's syndrome

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World Journal of Gastroenterology 2005年第29期11卷 4607-4609页

作者： Dario Sorrentino massimo Bazzocchi Luigi Badano Francesco Toso pietro Giagu GI Unit-Internal Medicine of the Department of Clinical and Experimental Pathology and Department of Radiology University of Udine School of Medicine and division of Cardiology Udine General Hospital Udine Italy

Symptomatic hepato-diaphragmatic interposition of a bowel loop or Chilaiditi's syndrome is a peculiar anatomical condition most often found by chance. Its described symptoms range from intermittent, mild abdominal pain and dyspepsia to acute intestinal obstruction. We report a case of hepato-diaphragmatic migration of the hepatic flexure of the colon associated to an unusual, heretofore unreported, angina-like pain exclusively evoked by the left lateral decubitus. To maximize the chance of observing anatomical changes in different postures, computed tomography of the chest and abdomen was performed after air insufflation into the colon. While frank herniation into the chest was excluded, the scan showed that the hepatic flexure-with the interposition of the diaphragm-came in contact with the right side of the heart in the left lateral, but not in the supine, decubitus. This finding was reproduced by echocardiography which also showed virtually unaltered hemodynamics after the change of posture. ECG, left and right ventricular global and regional function as well as cardiac injury markers also remained unchanged during the maneuver, indicating that the pain evoked by the latter was unlikely due to myocardial ischemia. This case suggests that Chilaiditi's syndrome should be included among the possible, although rare,causes of unexplained angina-like symptoms.

关键词： Chilaiditi's syndrome Hepatodiaphragmatic interposition Precordial pain

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The Stony Soils Reclamation Systems in Agricultural Lands: A Review

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Agricultural Sciences 2022年第4期13卷 500-519页

作者： pietro Toscano massimo Brambilla Maurizio Cutini Carlo Bisaglia CREA Research Centre for Engineering and Agri-Food Processing Treviglio Bergamo Italy

The agricultural soil is a highly variable and complex active medium for the plant’s life. Due to prolonged formation processes, it must be considered as a non-renewable resource, easily subject to many degradative processes, in most cases due to human activities. These activities lead to the definition of “anthropic” soils, often labelled also as “disturbed”, “manipulated”, “artificial”, or “deviations” of the natural soil continuum. In the agronomic sense, however, when these deviations result from the optimization of structural characteristics of fine earth fractions, they may represent the main quality parameters of soil in terms of physical, chemical, and biological fertility. Nevertheless, over the fine earth fractions, many agricultural soils have a variable percentage of varying coarse fractions in their arable layer, interfering with cultivation needs, damaging the machinery, and requiring extra energy and time for soil tillage. They may even make the use of machinery impracticable. When these conditions occur, it becomes necessary to proceed with soil destoning to recover arable land and optimize the cultural management according to modern farming techniques and machines for soil cultivation. The research aimed at evaluating the different possibilities of reclamation of stony soils and the machines that can be used in different environmental conditions, according to the various cultivation needs, and for the recovery and optimization of the non-renewable resource “soil”. This review briefly summarizes the soil destoning techniques currently available for agricultural lands: 1) the collection and removal of stones from the field;2) the on-site stones crushing;3) the stone burial.

关键词： Agricultural Sustainability Soil Quality Stoniness Soil Destoning Systems

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