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Clinical features and natural history of cryptogenic cirrhosis compared to hepatitis C virus-related cirrhosis

World Journal of Gastroenterology 2017年第8期23卷 1458-1468页

作者： Luca Rinaldi Fabio Nascimbeni Mauro Giordano Chiara Masetti Barbara Guerrera Annalisa Amelia Maria Chiara Fascione Stefano Ballestri Dante Romagnoli Rosa Zampino Riccardo Nevola Enrica Baldelli natalina iuliano Valerio Rosato Amedeo Lonardo Luigi Elio Adinolfi Internal Medicine Clinical Hospital of MarcianiseSecond University of Naples Department of Medical SurgicalNeurologicalMetabolicand Geriatric SciencesSecond University of Naples Outpatient Liver Clinic and Internal Medicine NOCSAEBaggiovaraAzienda USLModena Internal Medicine Pavullo HospitalAzienda Sanitaria Locale

AIM To characterize natural history of cryptogenic cirrhosis(CC) and compare its clinical features and outcomes to those of hepatitis C virus(HCV)-related *** A prospective cohort of 102 consecutive patients at their first diagnosis of CC were enrolled in this study. The clinical data and outcomes were compared to an ageand Child-pugh class-matched cohort of 110 patients with HCV-related cirrhosis. Diagnosis of cirrhosis was based on compatible clinical and laboratory parameters, ultrasound/endoscopic parameters and, whenever possible, on histological grounds and transient elastography. All cases of cirrhosis without a definite etiology were enrolled in the CC group. The parameters assessed were:(1) severity of liver disease at the time of first diagnosis;(2) liver decompensation during follow-up;(3) hepatocellular carcinoma(HCC);(4) orthotopic liver transplantation; and(5) death. The independent associated factors were evaluated by multiple logistic regression analysis, and survival and its determinants by the Kaplan-Meier model, log-rank test and Cox *** At the first observation, median age was 66 and 65 years and male gender was 36% and 58% for CC and HCV cirrhosis, respectively. CC showed Child-pugh class A/B/C of 47%/31%/22%, respectively. Compared to HCV cirrhosis, CC exhibited a significantly higher prevalence of metabolic syndrome(12% vs 54%, respectively), overweight/obesity, high BMI, impaired glucose tolerance, high blood pressure, dyslipidemia, hyperuricemia, cardiovascular diseases, extrahepatic cancer, and gallstones. Over a median period of 42 mo of follow-up, liver decompensation, HCC development and death for CC and HCV-related cirrhosis were 60.8%, and 54.4%, 16.7% and 17.2%, 39.2% and 30%, respectively. The median survival was 60 mo for CC. Independent predictors of death were age and Childpugh class at diagnosis. CC showed an approximately twofold higher incidence of HCC in Child-pugh class *** Undiagnosed no

关键词：肝肝硬化 Hepatocellular 癌新陈代谢的症候群不含酒精的脂肪肝疾病心血管的疾病

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Designing Locally Relevant Instructional Material for Indonesian EFL Classroom

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Journal of Linguistics and Education Research 2022年第1期5卷 14-19页

作者： natalina Asi Maria A.Luardini Merilyn Simbolon English Education Department Faculty of Teacher Training and EducationUniversity of Palangka RayaIndonesia

Meaningful teaching and learning can be achieved when the materials are closely related to the learners’real *** research focuses on language and culture for the materials suitable for the first semester students of EFL class at the University of Palangka *** design-based research was applied to provide sources consisting of environmental linguistic expres-sions within the eco-linguistic perspective and using a text-based or gen-re-based approach by selecting suitable texts for the *** Product of Instructional Material shows at least two benefits:(1)as the source of the main module of Intensive Course in writing skill for the first-year students of English Education in Central Kalimantan,and(2)the solution for en-couraging the teachers to modify the provided material which can cover the national standard(KKNI)as well as promoting the local values to strength-en local cultures to have meaningful teaching and learning process.

关键词： Eco-linguistics Local cultures Genre-based approach Material development

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Test-based exclusion diets in gastro-esophageal reflux disease patients:A randomized controlled pilot trial

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World Journal of Gastroenterology 2014年第45期20卷 17190-17195页

作者： Michele Caselli Giovanni Zuliani Francesca Cassol Nadia Fusetti Elena Zeni natalina Lo Cascio Cecilia Soavi Sergio Gullini Department of Medical Sciences Internal Medicine Institute University of Ferrara Department of Gastroenterology School of Gastroenterology University of Ferrara Center Study Association on Food Intolerance and Nutrition of Ferrara

AIM:To investigate the clinical response of gastroesophageal reflux disease(GERD)symptoms to exclusion diets based on food intolerance ***:A double blind,randomized,controlled pilot trial was performed in 38 GERD patients partially or completely non-responders to proton pump inhibitors(PPI)*** blood samples from each patients were obtained;leukocytotoxic test was performed by incubating the blood with a panel of 60food items to be *** reaction of leukocytes(rounding,vacuolization,lack of movement,flattening,fragmentation or disintegration of cell wall)was then evaluated by optical microscopy and rated as follows:level 0=negative,level 1=slightly positive,level 2=moderately positive,and level 3=highly positive.A"true"diet excluding food items inducing moderatesevere reactions,and a"control"diet including them was developed for each ***,twenty patients received the"true"diet and 18 the"control"diet;after one month(T1)symptoms severity was scored by the GERD impact scale(GIS).Hence,patients in the"control"group were switched to the"true"diet,and symptom severity was re-assessed after three months(T2).RESULTS:At baseline(T0)the mean GIS global score was 6.68(range:5-12)with no difference between"true"and control group(6.6±1.19 vs 6.7±1.7).All patients reacted moderately/severely to at least 1 food(range:5-19),with a significantly greater number of food substances inducing reaction in controls compared with the"true"diet group(11.6 vs 7.0,P<0.001).Food items more frequently involved were milk,lettuce,brewer’s yeast,pork,coffee,rice,sole asparagus,and tuna,followed by eggs,tomato,grain,shrimps,and chemical *** T1 both groups displayed a reduction of GIS score("true"group 3.3±1.7,-50%,P=0.001;control group 4.9±2.8,-26.9%,P=0.02),although the GIS score was significantly lower in"true"vs"control"group(P=0.04).At T2,after the diet switch,the"control"group showed a further reduction in GIS score(2.7±1.9,-44.9%,P=0.01),while the"true

关键词： Gastro-esophageal reflux disease Food intol-erance

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