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diagnostic accuracy of a new point-of-care screening assay for celiac disease

World Journal of Gastroenterology 2013年第31期19卷 5111-5117页

作者： Faiza Benkebil Christophe Combescure Silvia I Anghel Cécile Besson Duvanel michela G Schppi Vidymed 1007 Lausanne Switzerland CRC and division of Clinical Epi-demiology Department of Health and Community MedicineUniversity of Geneva and University Hospitals of Geneva 1007 Geneva Switzerland R and D Department Augurix BioArk 1870 Monthey Switzerland Scientific Officer Augurix BioArk1870 Monthey Switzerland Pediatric Gastroenterology Unit Pediatrics Department Geneva University Hospitals 1211 GenevaSwitzerland

AIM: To determine the diagnostic accuracy of a new point-of-care assay detecting anti-deamidated gliadin peptides in celiac disease(CD) ***: One-hundred-and-twelve patients(age range: 1.8-79.2 years old) with clinical symptoms suggestive of CD and/or first-degree relatives(FDR) of CD patients(n = 66),and confirmed CD on a gluten-free diet(GFD)(n = 46),were prospectively enrolled in the study at Gastroenterology outpatient clinics for adult patients and from the Gastroenterology Consultation Ward at the Pediatric Department of the University Hospital of *** informed consent was obtained from all subjects *** study received approval from the local ethics *** original CD diagnosis had been based on serum-positive IgA anti-tissue transglutaminase enzyme-linked immunosorbent assay(ELISA)(QuantaLite,Inova diagnostics,San diego,CA,United States) and on biopsy *** samples from all study participants were tested by the new CD lateral flow immunochromatographic assay(CD-LFIA) device,Simtomax Blood Drop(Augurix SA,BioArk,Monthey,Switzerland) to detect immunoglobulin(Ig)A and IgG antibodies against deamidated gliadin *** diagnostic performance was evaluated using receiver operating characteristic curves with 95%CIs.A cut-off of 2 on the Rann colorimetric scale was used to calculate the device's sensitivity and ***: CD-LFIA was highly accurate in detecting untreated celiac *** the group of patients with CD symptoms and/or FDR,eight new cases of CD were detected by ELISA and *** of these new cases were also correctly identified by *** test yielded four false positive and four false negative *** false positive results were all within the groups with clinical symptoms suggestive of CD and/or FDR,whereas the false negative results were all within the GFD *** test yeld a sensitivity of 78.9%(95%CI: 54.4-93.9) and specificity of 95.7%(95%CI: 89.4-98.8),and the area under

关键词： Celiac disease Deamidated gliadin Total immunoglobulin A Screening Point-of-care assay

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Anastomotic leakage in rectal cancer surgery:Retrospective analysis of risk factors

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World Journal of Clinical Cases 2022年第36期10卷 13321-13336页

作者： Giuseppe Brisinda Maria michela Chiarello Gilda Pepe Maria Cariati Valeria Fico Paolo Mirco Valentina Bianchi Department of Medical and Surgical Sciences Fondazione Policlinico Universitario A Gemelli IRCCSRome 00168Italy Department of Surgery UniversitàCattolica S CuoreRome 00168Italy Department of Surgery Azienda Sanitaria Provinciale di CosenzaCosenza 87100Italy Emergency Surgery and Trauma Center Fondazione Policlinico Universitario A Gemelli IRCCSRome 00168Italy Department of Surgery Azienda Sanitaria Provinciale di CrotoneCrotone 88900Italy

BACKGROUND Anastomotic leakage(AL)after restorative surgery for rectal cancer(RC)is associated with significant morbidity and *** To ascertain the risk factors by examining cases of AL in rectal surgery in this retrospective cohort *** To identify risk factors for AL,a review of 583 patients who underwent rectal resection with a double-stapling colorectal anastomosis between January 2007 and January 2022 was ***,demographic and operative features,intraoperative outcomes and oncological characteristics were *** The incidence of AL was 10.4%,with a mean time interval of 6.2±2.1 *** mortality was 0.8%.Mortality was higher in patients with AL(4.9%)than in patients without leak(0.4%,P=0.009).Poor bowel preparation,blood transfusion,median age,prognostic nutritional indexdiameter and intraoperative blood loss were identified as risk factors for *** of anastomosis,number of stapler cartridges used to divide the rectum,diameter of circular stapler,level of vascular section,T and N status and stage of disease were also correlated to AL in our *** diverting ileostomy did not reduce the leak rate,while the use of the transanastomic tube significantly *** Clinical,surgical and pathological factors are associated with an increased risk of *** adversely affects the morbidity and mortality of RC patients.

关键词： Anastomosis Leak Anterior resection Morbidity Mortality Rectal surgery

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Liver pathology in COVID-19 related death and leading role of autopsy in the pandemic

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World Journal of Gastroenterology 2023年第1期29卷 200-220页

作者： Martina Zanon Margherita Neri Stefano Pizzolitto Davide Radaelli Monica Concato michela Peruch Stefano D'Errico Department of Medical Surgical and Health Sciences University of TriesteTrieste 34149Italy Department of Medical Sciences University of FerraraFerrara 44121Italy Department of Pathology Santa Maria della Misericordia University HospitalUdine 33100Italy

BACKGROUND Information on liver involvement in patients with coronavirus disease 2019 is currently *** To highlight the pathological changes found during the autopsy of severe acute respiratory syndrome coronavirus 2 positive *** A systematic literature search on PubMed was carried out until June 21,*** A literature review reveals that pre-existing liver disease and elevation of liver enzyme in these patients are not common;liver enzyme elevations tend to be seen in those in critical *** the poor expression of viral receptors in the liver,it seems that the virus is able to infect this organ and therefore cause liver ***,to date,the search for the virus inside the liver is not frequent(16%of the cases)and only a small number show the presence of the *** most of the autopsy cases,macroscopic assessment is lacking,while microscopic evaluation of livers has revealed the frequent presence of congestion(42.7%)and steatosis(41.6%).Less frequent is the finding of hepatic inflammation or necrosis(19%)and portal inflammation(18%).The presence of microthrombi,frequently found in the lungs,is infrequent in the liver,with only 12%of cases presenting thrombotic formations within the vascular *** To date,the greatest problem in interpreting these modifications remains the association of the damage with the direct action of the virus,rather than with the inflammation or alterations induced by hypoxia and hypovolemia in patients undergoing oxygen therapy and decompensated patients.

关键词： Liver COVID-19 Autopsy Immunohistochemistry In situ hybridization Immunofluorescence

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Between Algorithm and Model:different Molecular Surface Definitions for the Poisson-Boltzmann Based Electrostatic Characterization of Biomolecules in Solution

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Communications in Computational Physics 2013年第1期13卷 61-89页

作者： Sergio Decherchi Jose Colmenares Chiara Eva Catalano michela Spagnuolo Emil Alexov Walter Rocchia Department of Drug discovery and Development Istituto Italiano di Tecnologiavia Morego3016163 GenovaItaly Institute for Applied Mathematics and Information Technologies National Research Council of ItalyGenoaItaly Department of Physics Clemson UniversityClemsonSouth CarolinaUSA

The definition of a molecular surface which is physically sound and computationally efficient is a very interesting and long standing problem in the implicit solvent continuum modeling of biomolecular systems as well as in the molecular graphics *** this work,two molecular surfaces are evaluated with respect to their suitability for electrostatic computation as alternatives to the widely used Connolly-Richards surface:the blobby surface,an implicit Gaussian atom centered surface,and the skin *** figures of merit,we considered surface differentiability and surface area continuity with respect to atom positions,and the agreement with explicit solvent *** analysis seems to privilege the skin to the blobby surface,and points to an unexpected relationship between the non connectedness of the surface,caused by interstices in the solute volume,and the surface area dependence on atomic *** order to assess the ability to reproduce explicit solvent results,specific software tools have been developed to enable the use of the skin surface in PoissonBoltzmann calculations with the DelPhi *** results indicate that the skin and Connolly surfaces have a comparable performance from this last point of view.

关键词： Molecular surface Connolly surface blobby surface skin surface Poisson-Boltzmann

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Therapeutic strategies in Crohn’s disease in an emergency surgical setting

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World Journal of Gastroenterology 2022年第18期28卷 1902-1921页

作者： Maria michela Chiarello Gilda Pepe Valeria Fico Valentina Bianchi Giuseppe Tropeano Gaia Altieri Giuseppe Brisinda Department of Surgery San Giovanni in Fiore HospitalAzienda Sanitaria Provinciale di CosenzaCosenza 87100Italy Emergency Surgery and Trauma Center Fondazione Policlinico Universitario A Gemelli IRCCSRome 00168Italy Department of Surgery Fondazione Policlinico Universitario A Gemelli IRCCSRome 00168Italy Medical and Surgical Science UniversitàCattolica del Sacro CuoreRome 00168Italy

Crohn’s disease(CD)remains a chronic,incurable disorder that presents unique challenges to the *** factors must be considered to allow development of an appropriate treatment *** therapy often precedes or complements the surgical *** indications for operative management of CD include acute and chronic disease complications and failed medical *** surgery comes into play when patients are refractory to medical treatment if they have an obstructive *** colitis,acute obstruction,perforation,acute abscess,or massive hemorrhage represent indications for emergency *** patients are generally in critical conditions and present with intra-abdominal sepsis and a preoperative status of immunosuppression and malnutrition that exposes them to a higher risk of complications and mortality.A multidisciplinary team including surgeons,gastroenterologists,radiologists,nutritional support services,and enterostomal therapists are required for optimal patient care and decision *** of each emergency should be individualized based on patient age,disease type and duration,and patient goals of ***,the recurrent nature of disease mandates that we continue searching for innovative medical therapies and operative techniques that reduce the need to repeat surgical *** this review,we aimed to discuss the acute complications of CD and their treatment.

关键词： Crohn’s disease Intestinal obstruction Free perforation Intra-abdominal sepsis Perineal sepsis Acute bleeding

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Early gastric cancer:A challenge in Western countries

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World Journal of Gastroenterology 2022年第7期28卷 693-703页

作者： Maria michela Chiarello Valeria Fico Gilda Pepe Giuseppe Tropeano Neill James Adams Gaia Altieri Giuseppe Brisinda Department of Surgery Azienda Sanitaria Provinciale di CrotoneOspedale San Giovanni di DioCrotone 88900Italy Emergency Surgery and Trauma Center Fondazione Policlinico Universitario A Gemelli IRCCSRome 00168Italy Health Sciences Clinical Microbiology UnitMagna Grecia UniversityCatanzaro 88100Italy Department of Medical and Surgical Sciences Catholic School of MedicineRome 00168Italy Department of Surgery Fondazione Policlinico Universitario A Gemelli IRCCSRome 00168Italy

Early gastric cancer(EGC)is an invasive carcinoma involving only the stomach mucosa or submucosa,independently of lymph node *** represents over 50%of cases in Japan and in South Korea,whereas it accounts only for approximately 20%of all newly diagnosed gastric cancers in Western *** main classification systems of EGC are the Vienna histopathologic classification and the Paris endoscopic classification of polypoid and non-polypoid lesions.A careful endoscopic assessment is fundamental to establish the best treatment of ***,EGCs are curable if the lesion is completely removed by endoscopic resection or *** types of EGC can be resected endoscopically;for others the most appropriate treatment is surgical resection and D2 lymphadenectomy,especially in Western *** favorable oncological prognosis,the extended lymphadenectomy and the reconstruction of the intestinal continuity that excludes the duodenum make the prophylactic cholecystectomy mandatory to avoid the onset of biliary complications.

关键词： Early gastric cancer diagnosis Treatment Endoscopic resection Surgery Lymph nodes metastases

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Optic nerve compression:the role of the lamina cribrosa and translaminar pressure

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International Journal of Ophthalmology(English edition) 2017年第12期10卷 1883-1888页

作者： mario r romano gilda cennamo maria angelica breve michela piedepalumbo claudio iovino nunzio velotti giovanni cennamo department of biomedical sciences humanitas universityMilan 20089Ital department of public health university of naples federicoⅡNaples 80131Italy department of neurosciences reproductive sciences and dentistryuniversity of naples federicoⅡNaples 80100Italy

AIM： To describe the morphological changes of the lamina cribrosa （LC） in patients with optic nerve compression. METHODS： Cross-sectional study. Twenty eyes with optic nerve compression, affected by Graves＇ ophthalmopathy （GO） were compared with 18 refractive error-matched healthy eyes. The following examinations were performed： best-corrected visual acuity （BCVA）, intraocular pressure, optic nerve echography, visual field, SD-OCT including the retinal nerve fiber layer （RNFL）, ganglion cell complex （GCC）, and LC thickness and extent. RESULTS： A-scan revealed significant differences in the subarachnoid space （SAS） between the affected and control groups. LC thickness and LC area were 233 pm （SD 23） and 0.41 mm2 （SD 0.19）, respectively. Average GCC thickness （P=-0.0005）, LC thickness （P=-0.001）, MD （P=-0.001） and PSD （P=-0.001） differed significantly between the two groups; whereas LC area （P=-0.2） and average RFNL （P=-0.1） did not. CONCLUSION： Optic nerve compression reduces the SAS thereby altering the morphology of LC thickness and causing GCC damage.

关键词： optic nerve compression lamina cribrosa translaminar pressure

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Locally advanced rectal cancer:The importance of a multidisciplinary approach

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World Journal of Gastroenterology 2014年第46期20卷 17279-17287页

作者： Rossana Berardi Elena Maccaroni Azzurra Onofri Francesca Morgese Mariangela Torniai michela Tiberi Consuelo Ferrini Stefano Cascinu Medical Oncology Università Politecnica delle MarcheAzienda OspedalieroUniversitaria Ospedali Riuniti Umberto IGM LancisiG Salesi di Ancona60126 AnconaItaly

Rectal cancer accounts for a relevant part of colorectal cancer cases,with a mortality of 4-10/100000 per *** development of locoregional recurrences and the occurrence of distant metastases both influences the prognosis of these *** the last two decades,new multimodality strategies have improved the prognosis of locally advanced rectal cancer with a significant reduction of local relapse and an increase in terms of overall *** surgery still remains the principal curative treatment and the introduction of total mesorectal excision has significantly achieved a reduction in terms of local recurrence *** employment of neoadjuvant treatment,delivered before surgery,also achieved an improved local control and an increasedsphincter preservation rate in low-lying tumors,with an acceptable acute and late *** review describes the multidisciplinary management of rectal cancer,focusing on the effectiveness of neoadjuvant chemoradiotherapy and of post-operative adjuvant chemotherapy both in the standard combined modality treatment programs and in the ongoing research to improve these regimens.

关键词： Locally advanced rectal cancer Neo-adjuvant treatment Radio-chemotherapy Surgery Adjuvant treatment Target drugs

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Pacemaker therapy in very elderly patients: survival and prognostic parameters of single center experience

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Journal of Geriatric Cardiology 2019年第12期16卷 880-884页

作者： Massimiliano Marini Marta Martin michela Saltori Silvia Quintarelli Filippo Zilio Fabrizio Guarracini Alessio Coser Sergio Valsecchi Roberto Bonmassari Department of Cardiology S.Chiara HospitalTrentoItaly CRM Department Boston ScientificMilanItaly

Background Permanent pacing is the therapy of choice for treating severe and/or symptomatic bradyarrhythmias. The number of very elderly patients receiving pacemakers is increasing and little is known about survival in this specific subgroup. This study is aimed at assessing the actual survival of patients requiring pacing therapy at age > 85 years and investigating variables associated with death. Methods Between 2010 and 2017, 572 patients aged ≥ 85 years underwent pacemaker implantation for conventional bradycardia indications in Department of Cardiology, S. Chiara Hospital, Italy. Results Thirty percent of patients were ≥ 90-year-old and comorbidities were frequent. Fifty-seven percent of patients required pacing for prognostic reasons(acquired atrioventricular block), and the remaining for relief of bradycardia symptoms. A dual-chamber pacemaker was implanted in 34% of patients. The 5-year survival was 45%(standard error: 3%), and the 8-year survival was 26%(standard error: 4%). The risk of death was similar in patients who received pacemaker for symptom relief and for prognostic reasons in the overall population(HR = 1.19, 95% CI: 0.93–1.52, P = 0.156), as well as in the ≥ 90-year-old group(HR = 1.39, 95% CI: 0.92–2.11, P = 0.102). At multivariate analysis, following variables were associated with death: higher age, lower ejection fraction, dementia/dysautonomia and diagnosis of cancer. The pacing indication and the implantation of a single chamber pacemaker were not associated with worse prognosis. Conclusions This study showed a good life expectancy in patients aged ≥ 85 years who received a pacemaker. Strong risk factors for all-cause death were non-cardiac. Pacemaker therapy seems a clinically effective therapeutic option to improve survival and to control bradyarrhythmia-related symptoms in very elderly patients.

关键词： Mortality Pacemaker The elderly

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Cell fusion in the liver, revisited

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World Journal of Hepatology 2018年第2期10卷 213-221页

作者： michela Lizier Alessandra Castelli Cristina Montagna Franco Lucchini Paolo Vezzoni Francesca Faggioli Istituto di Ricerca Genetica e Biomedica CNR Human Genome Laboratory Humanitas Clinical and Research Center IRCCS Department of Genetics and Pathology Genetics Albert Einstein College of Medicine Centro Ricerche Biotecnologiche Università Cattolica del Sacro Cuore

There is wide agreement that cell fusion is a physiological process in cells in mammalian bone, muscle and placenta. In other organs, such as the cerebellum, cell fusion is controversial. The liver contains a considerable number of polyploid cells: They are commonly believed to originate by genome endoreplication, although the contribution of cell fusion to polyploidization has not been excluded. Here, we address the topic of cell fusion in the liver from a historical point of view. We discuss experimental evidence clearly supporting the hypothesis that cell fusion occurs in the liver, specifically when bone marrow cells were injected into mice and shown to rescue genetic hepatic degenerative defects. Those experiments-carried out in the latter half of the last century-were initially interpreted to show "transdifferentiation", but are now believed to demonstrate fusion between donor macrophages and host hepatocytes, raising the possibility that physiologically polyploid cells, such as hepatocytes, could originate, at least partially, through homotypic cell fusion. In support of the homotypic cell fusion hypothesis, we present new data generated using a chimera-based model, a much simpler model than those previously used. Cell fusion as a road to polyploidization in the liver has not been extensively investigated, and its contribution to a variety of conditions, such as viral infections, carcinogenesis and aging, remains unclear.

关键词： Cell fusion Hepatocytes TdTomato Lineage tracing Chimeras Extracellular vesicles

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