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World Journal of Gastroenterology 2018年第31期24卷 3469-3471页

作者： Quirino Lai michele di martino Pierleone Lucatelli Gianluca Mennini Department of General Surgery and Organ Transplantation Sapienza University of Rome Department of Radiology Sapienza University of Rome

Locoregional treatments(LRT) represent a broad strategy used for reducing the risk of drop-off and contextually improving the survivals in patients with hepatocellular cancer receiving a liver transplantation(LT). However, it is not sufficiently clear if LRT are only a surrogate of tumor aggressiveness or if they consent a real benefit in terms of tumor stabilization. A recent study by Pommergaard et al reported the results from the European Liver Transplant Registry. Patients receiving LRT before LT had better 5-year survival rates respect to no-LRT cases(69.7% vs 65.8%; P discordance with other analyses showing a detrimental effect of LRT. The main problem in the interpretation of these results is connected with the possible initial selection biases present in the studies. The most recent guidelines suggest to perform LRT before the transplant, but the level of evidence is typically low due to the absence of prospectively designed studies.

关键词： Allocation Recurrence Trans-arterial chemo-embolization Radiofrequency ablation Model for end-stage liver disease

Comparison of magnetic resonance spectroscopy, proton density fat fraction and histological analysis in the quantification of liver steatosis in children and adolescents

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World Journal of Gastroenterology 2016年第39期22卷 8812-8819页

作者： michele di martino Lucia Pacifico Mario Bezzi Rossella di Miscio Beatrice Sacconi Claudio Chiesa Carlo Catalano Department of Radiological Sciences Oncology and Anatomical Pathology "Sapienza" University of Rome Department of Pediatrics and Child Neuropsychiatry "Sapienza" University of Rome Institute of Translational Pharmacology National Research Council

AIM To establish a threshold value for liver fat content between healthy children and those with nonalcoholic fatty liver disease(NAFLD) by using magnetic resonance imaging(MRI), with liver biopsy serving as a reference standard. METHODS The study was approved by the local ethics committee, and written informed consent was obtained from all participants and their legal guardians before the study began. Twenty-seven children with NAFLD underwent liver biopsy to assess the presence of nonalcoholic steatohepatitis. The assessment of liver fat fraction was performed using MRI, with a high field magnet and 2D gradient-echo and multiple-echo T1-weighted sequence with low flip angle and single-voxel pointresolved 1H MR-Spectroscopy(1H-MRS), corrected for T1 and T2* decays. Receiver operating characteristic curve analysis was used to determine the best cutoff value. Lin coefficient test was used to evaluate thecorrelation between histology, MRS and MRI-PDFF. A Mann-Whitney U-test and multivariate analysis were performed to analyze the continuous variables. RESULTS According to MRS, the threshold value between healthy children and those with NAFLD is 6%; using MRI-PDFF, a cut-off value of 3.5% is suggested. The Lin analysis revealed a good fit between the histology and MRS as well as MRI-PDFF.CONCLUSION MRS is an accurate and precise method for detecting NAFLD in children.

关键词：磁性的回声光谱学磁性的回声 imaging-PDFF 肥胖非酒精的脂肪肝疾病孩子

T1-weighted dual-echo MRI for fat quantification in pediatric nonalcoholic fatty liver disease

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World Journal of Gastroenterology 2011年第25期17卷 3012-3019页

作者： Lucia Pacifico michele di martino Carlo Catalano Valeria Panebianco Mario Bezzi Caterina Anania Claudio Chiesa Department of Pediatrics Sapienza University of Rome Department of Radiological Sciences Sapienza University of Rome Institute of Translational Pharmacology National Research Council

AIM:To determine in obese children with nonalcoholic fatty liver disease (NAFLD) the accuracy of magnetic resonance imaging (MRI) in assessing liver fat concentration.METHODS:A case-control study was performed.Cases were 25 obese children with biopsy-proven NAFLD.Controls were 25 obese children matched for age and gender,without NAFLD at ultrasonography and with normal levels of aminotransferases and insulin.Hepatic fat fraction (HFF) by MRI was obtained using a modification of the dixon method.RESULTS:HFF ranged from 2% to 44% [mean,19.0% (95% CI,15.1-27.4)] in children with NAFLD,while in the controls this value ranged from 0.08% to 4.69% [2.0% (1.3-2.5),P ding to the histological grade of steatosis,the mean HFF was 8.7% (95% CI,6.0-11.6) for mild,21.6% (15.3-27.0) for moderate,and 39.7% (34.4-45.0) for severe fatty liver infiltration.With a cutoff of 4.85%,HFF had a sensitivity of 95.8% for the diagnosis of histological steatosis ≥ 5%.All control children had HFF lower than 4.85%;thus,the specificity was 100%.After 12 mo,children with weight loss displayed a significant decrease in HFF.CONCLUSION:MRI is an accurate methodology for liver fat quantification in pediatric NAFLD.

关键词：脂肪肝 MRI 酒精性儿童肝病加权回波磁共振成像

Pancreatic fat and β-cell function in overweight/obese children with nonalcoholic fatty liver disease

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World Journal of Gastroenterology 2015年第15期21卷 4688-4695页

作者： Lucia Pacifico michele di martino Caterina Anania Gian Marco Andreoli Mario Bezzi Carlo Catalano Claudio Chiesa Department of Pediatrics and Child Neuropsychiatry Sapienza University of Rome Department of Radiological Sciences Sapienza University of Rome Institute of Translational Pharmacology National Research Council

AIM: To analyze the associations of pancreatic fat with other fat depots and β-cell function in pediatric nonalcoholic fatty liver disease(NAFLD).METHODS: We examined 158 overweight/obese children and adolescents, 80 with NAFLD [hepatic fat fraction(HFF) ≥ 5%] and 78 without fatty liver. Visceral adipose tissue(VAT), pancreatic fat fraction(PFF) and HFF were determined by magnetic resonance imaging. Estimates of insulin sensitivity were calculated using the homeostasis model assessment of insulin resistance(HOMA-IR), defined by fasting insulin and fasting glucose and whole-body insulin sensitivity index(WBISI), based on mean values of insulin and glucose obtained from oral glucose tolerance test and the corresponding fasting values. Patients were considered to have prediabetes if they had either:(1) impaired fasting glucose, defined as a fasting glucose level ≥ 100 mg/d L to dized coefficient B,-0.398; P = 0.001) as well as HOMA-IR(0.353; P = 0.003) was HFF. Children with prediabetes had higher PFF and HFF than those without. PFF and HFF were significantly associated with prediabetes after adjustment for clinical variables. When all fat depots where included in the same model, only HFF remained significantly associated with prediabetes(OR = 3.38; 95%CI: 1.10-10.4; P

关键词： Nonalcoholic fatty liver disease Pancreaticfat Visceral fat Beta-cell function Children

Potential of GSHP coupled with PV systems for retrofitting urban areas in different European climates based on archetypes definition

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Energy and Built Environment

Energy and Built Environment 2024年第3期5卷 374-392页

作者： Laura Carnieletto Antonino di Bella Davide Quaggiotto Giuseppe Emmi Adriana Bernardi michele De Carli Department of Industrial Engineering–diI University of Padovavia Venezia 1PadovaItaly University of Ferrara Italy CNR–National Research Council PadovaItaly

According to the recent policies regarding energy use in buildings and the need of retrofit strategies,the aim of this work is to support policies concerning the installation of ground source heat exchangers in urban and historical areas,raising the awareness on the potential energy saving achievable with optimal sizing and limited impact on the urban environment.Archetypes have been developed distinguishing among existing and historic buildings,focusing on single-family terrace houses,which are the typical residential buildings in European historic centres.A methodology for the optimal sizing of ground source heat pumps,eventually considering dual-source system or air system has been developed combining simulations of a photovoltaic system to estimate the self-sufficiency and the self-consumption for five orientations of the building.Extreme results have been obtained for warm cli-mates,with negligible heating energy demand and possibly free cooling systems rather than traditional cooling systems needed in wintertime.Penalty temperature was acceptable despite unbalanced energy demands.With proper inclination,photovoltaic systems could provide up to 40%of self-sufficiency share also in northern cli-mates.An energy-economic analysis was carried out obtaining a variety of cases representing a general overview of the European building stock and the potential benefits achievable in terms of renewable energy share,energy savings and economic investments needed to be extended to simulations at urban scale.

关键词： Energy use database Ground source heat exchangers Urban context Energy retrofit Integrated renewables

Interplay between metabolic dysfunction-associated fatty liver disease and renal function: An intriguing pediatric perspective

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World Journal of Gastroenterology 2024年第15期30卷 2081-2086页

作者： michele Nardolillo Fabiola Rescigno Mario Bartiromo Dario Piatto Stefano Guarino Pierluigi Marzuillo Emanuele Miraglia del Giudice Anna di Sessa Department of Woman Child and of General and Specialized SurgeryUniversitàdegli Studi della Campania“Luigi Vanvitelli”Naples 80138Italy

Over recent years,the nomenclature of non-alcoholic fatty liver disease has undergone significant changes.Indeed,in 2020,an expert consensus panel proposed the term“Metabolic(dysfunction)associated fatty liver disease”(MAFLD)to underscore the close association of fatty liver with metabolic abnormalities,thereby highlighting the cardiometabolic risks(such as metabolic syndrome,type 2 diabetes,insulin resistance,and cardiovascular disease)faced by these patients since childhood.More recently,this term has been further replaced with metabolic associated steatotic liver disease.It is worth noting that emerging evidence not only supports a close and independent association of MAFLD with chronic kidney disease in adults but also indicates its interplay with metabolic impairments.However,comparable pediatric data remain limited.Given the progressive and chronic nature of both diseases and their prognostic cardiometabolic implications,this editorial aims to provide a pediatric perspective on the intriguing relationship between MAFLD and renal function in childhood.

关键词： Metabolic(dysfunction)associated fatty liver disease Renal Function Children Obesity

Transurethral prostate surgery in prostate cancer patients: A population-based comparative analysis of complication and mortality rates

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Asian Journal of Urology 2024年第1期11卷 48-54页

作者： michele Marchioni Giulia Primiceri Alessandro Veccia Marta di Nicola Umberto Carbonara Fabio Crocerossa Ugo Falagario Ambra Rizzoli Riccardo Autorino Luigi Schips Laboratory of Biostatistics Department of MedicalOral and Biotechnological Sciences“G.d'Annunzio”University of ChietiChietiItaly Urology Unit Department of MedicalOral and Biotechnological Sciences“G.d'Annunzio”University of ChietiChietiItaly division of Urology VCU HealthRichmondVAUSA

Objective:Prostate cancer(PCa)patients might experience lower urinary tract symptoms as those diagnosed with benign prostatic hyperplasia(BPH).Some of them might be treated for their lower urinary tract symptoms instead of PCa.We aimed to test the effect of PCa versus BPH on surgical outcomes after transurethral prostate surgery,namely complication and mortality rates.Methods:Within the American College of Surgeons National Surgical Quality Improvement Program database(2011-2016),we identified patients who underwent transurethral resection of the prostate,photoselective vaporization,or laser enucleation.Patients were stratified according to postoperative diagnosis(PCa vs.BPH).Univariable and multivariable logistic regression models evaluated the predictors of perioperative morbidity and mortality.A formal test of interaction between diagnosis and surgical technique used was performed.Results:Overall,34542 patients were included.Of all,2008(5.8%)had a diagnosis of PCa.The multivariable logistic regression model failed to show statistically significant higher rates of postoperative complications in PCa patients(odds ratio:0.9,95%confidence interval:0.7-1.1;p=0.252).Moreover,similar rates of perioperative mortality(p=0.255),major acute cardiovascular events(p=0.581),transfusions(p=0.933),and length of stay of more than or equal to 30 days(p=0.174)were found.Additionally,all tests failed to show an interaction between post-operative diagnosis and surgical technique used.Conclusion:Patients diagnosed with PCa do not experience higher perioperative morbidity or mortality after transurethral prostate surgery when compared to their BPH counterparts.Moreover,the diagnosis seems to not influence surgical technique outcomes.

关键词： Prostatecancer Transurethral surgery of the prostate Prostate surgery Population-based analysis Benign prostatic hyperplasia Lasersurgery

A Number Theoretic Analysis of the Enthalpy, Enthalpy Energy Density, Thermodynamic Volume, and the Equation of State of a Modified White Hole, and the Implications to the Quantum Vacuum Spacetime, Matter Creation and the Planck Frequency

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Journal of Modern Physics 2024年第1期15卷 1-50页

作者： michele Nardelli Amos S. Kubeka Alizera Amani dipartimento di Scienze della Terra Università degli Studi di Napoli Federico II Naples Italy Department of Mathematical Sciences University of South Africa Unisa South Africa Department of Physics Ayatollah Amoli Branch Islamic Azad University Amol Iran

In this paper, we analyze the enthalpy, enthalpy energy density, thermodynamic volume, and the equation of state of a modified white hole. We obtain new possible mathematical connections with some sectors of Number Theory, Ramanujan Recurring Numbers, DN Constant and String Theory, that enable us to extract the quantum geometrical properties of these thermodynamic equations and the implication to the quantum vacuum spacetime geometry of our early universe as they act as the constraints to the nature of quantum gravity of the universe.

关键词： Number Theory Ramanujan Recurring Numbers DN Constant String Theory Loop Quantum Gravity Matter Creation Enthalpy Energy Density Thermodynamic Volume Enthalpy

Prevalence of bile reflux in gastroesophageal reflux disease patients not responsive to proton pump inhibitors

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World Journal of Gastroenterology 2009年第3期15卷 334-338页

作者： Luigi Monaco Antonio Brillantino Francesco Torelli michele Schettino Giuseppe Izzo Angelo Cosenza Natale di martino Department of General and Gastrointestinal Surgery School of MedicineSecond University of NaplesPiazza Miraglia 2Naples 80138Italy

AIM:To determine the prevalence and characteristics of bile reflux in gastroesophageal reflux disease(GERD) patients with persistent symptoms who are non-responsive to medical therapy.METHODS:Sixty-five patients(40 male,25 female;mean age,50 ± 7.8 years) who continued to report symptoms after 8 wk of high-dose proton pump inhibitor(PPI) therapy,as well as 18 patients with Barrett's esophagus,were studied.All patients filled out symptom questionnaires and underwent endoscopy,manometry and combined pH-metry and bilimetry.RESULTS:There were 4 groups of patients:22(26.5%) without esophagitis,24(28.9%) grade A-B esophagitis,19(22.8%) grade C-D and 18(21.6%) Barrett's esophagus.Heartburn was present in 71 patients(85.5%) and regurgitation in 55(66.2%),with 44(53%) reporting simultaneous heartburn and regurgitation.The prevalence of pathologic acid reflux in the groups without esophagitis and with grades A-B and C-D esophagitis was 45.4%,66.6% and 73.6%,respectively.The prevalence of pathologic bilirubin exposure in these 3 groups was 53.3%,75% and 78.9%,respectively.The overall prevalence of bile reflux in non-responsive patients was 68.7%.Pathologic acid and bile reflux was observed in 22.7% and 58.1% of non-esophagitic patients and esophagitic patients,respectively.CONCLUSION:The high percentage of patients poorly responsive to PPI therapy may result from poor control of duodenogastroesophageal reflux.Many patients without esophagitis have simultaneous acid and bile reflux,which increases with increasing esophagitis grade.

关键词：食管回流疾病胆汁回流胆红素 Barrett食道疾病

Laparoscopic calibrated total vs partial fundoplication following Heller myotomy for oesophageal achalasia

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World Journal of Gastroenterology 2011年第29期17卷 3431-3440页

作者： Natale di martino Antonio Brillantino Luigi Monaco Luigi Marano michele Schettino Raffaele Porfidia Giuseppe Izzo Angelo Cosenza VIII Department of General and Gastrointestinal Surgery School of MedicineSecond University of NaplesPiazza Miraglia 280138 NaplesItaly

AIM:To compare the mid-term outcomes of laparoscopic calibrated Nissen-Rossetti fundoplication with Dor fundoplication performed after Heller myotomy for oesophageal achalasia.METHODS:Fifty-six patients(26 men,30 women;mean age 42.8±14.7 years)presenting for minimally invasive surgery for oesophageal achalasia,were enrolled.All patients underwent laparoscopic Heller myotomy followed by a 180°anterior partial fundoplication in 30 cases(group 1)and calibrated NissenRossetti fundoplication in 26(group 2).Intraoperative endoscopy and manometry were used to calibrate the myotomy and fundoplication.A 6-mo follow-up period with symptomatic evaluation and barium swallow was undertaken.One and two years after surgery,the patients underwent symptom questionnaires,endoscopy,oesophageal manometry and 24 h oesophago-gastric pH monitoring.RESULTS:At the 2-year follow-up,no significant difference in the median symptom score was observed between the 2 groups(P=0.66;Mann-WhitneyU-test).The median percentage time with oesophageal pH< 4 was significantly higher in the Dor group compared to the Nissen-Rossetti group(2;range 0.8-10 vs 0.35;range 0-2)(P<0.0001;Mann-WhitneyU-test).CONCLUSION:Laparoscopic Dor and calibrated Nissen-Rossetti fundoplication achieved similar results in the resolution of dysphagia.Nissen-Rossetti fundoplication seems to be more effective in suppressing oesophageal acid exposure.

关键词：胃镜检查腹腔镜食管校准弛缓 VS 微创手术平均年龄