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Diagnostic yield of EUS-FNA of small(≤15 mm) solid pancreatic lesions using a 25-gauge needle

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Hepatobiliary & Pancreatic Diseases International 2018年第1期17卷 70-74页

作者： Stefano Francesco Crinò Maria Cristina Conti Bellocchi Laura Bernardoni Erminia Manfrin Alice Parisi Antonio Amodio nicolò de pretis Luca Frulloni Armando Gabbrielli Gastroenterology and Digestive Endoscopy Unit The Pancreas Institute University of Verona G.B. Rossi University Hospital department of Pathology University of Verona G.B. Rossi University Hospital

Background: Early detection of small solid pancreatic lesions is increasingly common. To date, few and contradictory data have been published about the relationship between lesion size and endoscopic ultrasound-guided fine needle aspiration(EUS-FNA) diagnostic yield. The aim of this study was to assess the relation between the size of solid pancreatic lesions and the diagnostic yield of EUS-FNA using a 25-gauge needle in a center without available rapid on-site evaluation.Methods: In the retrospective cohort study, we selected patients who underwent EUS-FNA for solid pancreatic lesions with a 25-gauge needle from October 2014 to October 2015. Patients were divided into three groups(≤15 mm, 16–25 mm and >25 mm), and the outcomes were compared.Results: We analyzed 163 patients. Overall adequacy, sensitivity, specificity and accuracy were 85.2%,81.8%, 93.7%, and 80.4%, respectively. When stratified by size, the sensitivity and accuracy correlated with size(P = 0.016 and P = 0.042, respectively). Multivariate analysis showed that lesion size was the only independent factor(P = 0.019, OR = 4.76) affecting accuracy. The role of size as an independent factor affecting accuracy was confirmed in a separate multivariate analysis, where size was included in the model as a covariate(P = 0.018, OR = 1.08).Conclusion: Our study demonstrates that, in the absence of rapid on-site evaluation, mass size affects the accuracy of EUS-FNA of solid pancreatic lesions.

关键词： Endoscopic ultrasound Endoscopic ultrasound-guided fine needle aspiration Pancreatic cancer Benign pancreatic tumors Pancreatic neoplasms

Imaging of paraduodenal pancreatitis:A systematic review

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World Journal of Radiology 2023年第2期15卷 42-55页

作者： Matteo Bonatti nicolòde pretis Giulia A Zamboni Alessandro Brillo Stefano Francesco Crinò Riccardo Valletta Fabio Lombardo Giancarlo Mansueto Luca Frulloni department of Radiology Ospedale Centrale di BolzanoBolzano 39100Italy Gastroenterology and Digestive Endoscopy Unit The Pancreas InstituteG.B.Rossi University Hospital of VeronaVerona 37134Italy department of Diagnostics and Public Health Radiology SectionPoliclinico GB RossiUniversity of VeronaVerona 37134VeronaItaly department of Medicine University of VeronaVerona 37134Italy department of Radiology IRCCS Sacro Cuore Don Calabria HospitalNegrar 37024Italy

BACKGROUND Paraduodenal pancreatitis(PP)represents a diagnostic challenge,especially in non-referral centers,given its potential imaging overlap with pancreatic cancer.There are two main histological variants of PP,the cystic and the solid,with slightly different imaging appearances.Moreover,imaging findings in PP may change over time because of disease progression and/or as an effect of its risk factors exposition,namely alcohol intake and smoking.AIM To describe multimodality imaging findings in patients affected by PP to help clinicians in the differential diagnosis with pancreatic cancer.METHODS The systematic review was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-analyses 2009 guidelines.A Literature search was performed on PubMed,Embase and Cochrane Library using(groove pancreatitis[Title/Abstract])OR(PP[Title/Abstract])as key words.A total of 593 articles were considered for inclusion.After eliminating duplicates,and title and abstract screening,53 full-text articles were assessed for eligibility.Eligibility criteria were:Original studies including 8 or more patients,fully written in English,describing imaging findings in PP,with pathological confirmation or clinical-radiological follow-up as the gold standard.Finally,14 studies were included in our systematic review.RESULTS Computed tomography(CT)findings were described in 292 patients,magnetic resonance imaging(MRI)findings in 231 and endoscopic ultrasound(EUS)findings in 115.Duodenal wall thickening was observed in 88.8%of the cases:detection rate was 96.5%at EUS,91.0%at MRI and 84.1%at CT.Second duodenal portion increased enhancement was recognizable in 76.3%of the cases:detection rate was 84.4%at MRI and 72.1%at CT.Cysts within the duodenal wall were detected in 82.6%of the cases:detection rate was 94.4%at EUS,81.9%at MRI and 75.7%at CT.A solid mass in the groove region was described in 40.9%of the cases;in 78.3%of the cases,it showed patchy enhancement in the portal venous phase,and in 100%appeared iso/hyperin

关键词： Pancreatitis Paraduodenal pancreatitis Diagnostic imaging Computed tomography Magnetic resonance imaging Endoscopic ultrasound

Therapeutic strategies for gastroenteropancreatic neuroendocrine neoplasms: State-of-the-art and future perspectives

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World Journal of Gastrointestinal Surgery 2022年第2期14卷 78-106页

作者： Elettra Merola Andrea Michielan Umberto Rozzanigo Marco Erini Sandro Sferrazza Stefano Marcucci Chiara Sartori Chiara Trentin Giovanni de pretis Franca Chierichetti department of Gastroenterology Santa Chiara HospitalAzienda Provinciale per i Servizi Sanitari(APSS)Trento 38122Italy department of Radiology Santa Chiara HospitalAzienda Provinciale per i Servizi Sanitari(APSS)Trento 38122Italy department of Nuclear Medicine Santa Chiara HospitalAzienda Provinciale per i Servizi Sanitari(APSS)Trento 38122Italy department of Surgery Santa Chiara HospitalAzienda Provinciale per i Servizi Sanitari(APSS)Trento 38122Italy department of Pathology Santa Chiara HospitalAzienda Provinciale per i Servizi Sanitari(APSS)Trento 38122Italy department of Medical Oncology Santa Chiara HospitalAzienda Provinciale per i Servizi Sanitari(APSS)Trento 38122Italy

Although gastroenteropancreatic neuroendocrine neoplasms(GEP-NENs)have always been considered rare tumors,their incidence has risen over the past few decades.They represent a highly heterogeneous group of neoplasms with several prognostic factors,including disease stage,proliferative index(Ki67),and tumor differentiation.Most of these neoplasms express somatostatin receptors on the cell surface,a feature that has important implications in terms of prognosis,diagnosis,and therapy.Although International Guidelines propose algorithms aimed at guiding therapeutic strategies,GEP-NEN patients are still very different from one another,and the need for personalized treatment continues to increase.Radical surgery is always the best option when feasible;however,up to 80%of cases are metastatic upon diagnosis.Regarding medical treatments,as GEP-NENs are characterized by relatively long overall survival,multiple therapy lines are adopted during the lifetime of these patients,but the optimum sequence to be followed has never been clearly defined.Furthermore,although new molecular markers aimed at predicting the response to therapy,as well as prognostic scores,are currently being studied,their application is still far from being part of daily clinical practice.As they represent a complex disease,with therapeutic protocols that are not completely standardized,GEP-NENs require a multidisciplinary approach.This review will provide an overview of the available therapeutic options for GEP-NENs and attempts to clarify the possible approaches for the management of these patients and to discuss future perspectives in this field.

关键词： Gastroenteropancreatic neuroendocrine neoplasms Therapeutic strategies Radical surgery Medical treatments Overview Future perspectives

Hepatitis C virus burden:Treating and educating people without prejudice

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World Journal of Hepatology 2022年第7期14卷 1495-1503页

作者： Elettra Merola Elisa Menotti Giovanna Branz Andrea Michielan Sonia Seligmann Annora Ratti Flora Agugiaro Luisa Moser Giovanni Vettori Anna Franceschini William Mantovani Riccardo Pertile Giovanni de pretis Cecilia Pravadelli department of Gastroenterology Santa Chiara HospitalAzienda Provinciale Per I Servizi Sanitari(APSS)Trento 38122Italy department of SerD Service for Drug AddictionAzienda Provinciale Per I Servizi Sanitari(APSS)Trento 38122Italy department of Prevention Azienda Provinciale Per I Servizi Sanitari(APSS)Trento 38122Italy department of Clinical and Evaluative Epidemiology Azienda Provinciale Per I Servizi Sanitari(APSS)Trento 38122Italy

Hepatitis C virus(HCV)infection has a worldwide incidence of 1.1%.In Italy,60%of people who inject drugs(PWIDs)and are receiving assistance for substance use disorder are infected with HCV.However,this subset of patients has extremely limited access to care due to multiple factors,including alcohol abuse,psychological comorbidities,and homeless status.AIM To describe the impact of our HCV-dedicated service for substance use disorder(SSUD)service on PWIDs receiving anti-HCV therapy.METHODS A dedicated,multidisciplinary team was set up at the SSUD of Trento in October 2020 to provide antiviral treatment to HCV RiboNucleic Acid-positive patients with an active or previous history of substance abuse.The treatment was followed by a health education program.Patients were treated with Direct-Acting Antivirals(DAAs).Data were retrospectively analyzed to assess the efficacy of our dedicated program in terms of therapy completion,HCV eradication,and compliance(primary endpoint).The rate of HCV reinfection and DAA-related toxicity were also assessed(secondary endpoints).RESULTS A total of 40 patients were enrolled in the study:28(70.0%)were treated with Sofosbuvir/Velpatasvir,while 12(30.0%)received Glecaprevir/Pibrentasvir.At the time of inclusion in the study,36 patients were receiving opioid agonist maintenance therapy,whilst another 4 had just finished the treatment.37.5%had a history of alcoholism and 42.5%received concomitant psychiatric treatment.All 40 patients(100.0%)completed the therapy cycle and 92.5%of patients adhered to the program.All patients tested negative for viral load at the end of the treatment.There were no significant drug interactions with common psychiatric treatments and no side effects were observed.The sustained virological response was achieved in 92.5%of cases with good tolerability,although two patients discontinued treatment temporarily.After HCV eradication,one patient died from an overdose,another from complications of cirrhosis,and one reinfection occurred.CONCLUSION Very high adherence

关键词： Hepatitis C virus Service for substance use disorder Direct-acting antivirals Sustained virologic response Compliance Tolerability

Familial colorectal cancer: A review

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World Journal of Gastroenterology 2014年第28期20卷 9292-9298页

作者： Franco Armelao Giovanni de pretis department of Gastroenterology Ospedale Santa ChiaraAzienda Provinciale per i Servizi Sanitari38122 TrentoItaly

Familial colorectal cancer constitutes a heterogeneous group of patients in whom the underlying molecular mechanism is still unknown.Predisposition to a such neoplasms in this setting seems to be due to common low-penetrance genetic components,but the role of genetic testing in clinical practice has to be determined.Although screening guidelines in this moderate-risk population are empiric,data obtained in epidemiologic,meta-analyses and cohort studies and,more recently,the increased risk of advanced adenomas in first degree relatives who underwent screening colonoscopy support the need to include these individuals in specific screening programs.However,data to determine what test to use,how often to use and which organizational strategy to implement are needed.At present,screening uptake in this population is less than optimal;offering the opportunity to access to screening and improving screening uptake is a first significant step.

关键词： Colorectal cancer Familial risk Heterogeneous Risk

Gastrointestinal tract injuries after thermal ablative therapies for hepatocellular carcinoma:A case report and review of the literature

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World Journal of Gastroenterology 2020年第35期26卷 5375-5386页

作者： Teresa Marzia Rogger Andrea Michielan Sandro Sferrazza Cecilia Pravadelli Luisa Moser Flora Agugiaro Giovanni Vettori Sonia Seligmann Elettra Merola Marcello Maida Francesco Antonio Ciarleglio Alberto Brolese Giovanni de pretis department of Surgery Gastroenterology and Digestive Endoscopy UnitSanta Chiara HospitalTrento 38122Italy Gastroenterology and Endoscopy Unit S.Elia-Raimondi HospitalCaltanissettaCaltanissetta 93100Italy department of Surgery Hepato-biliary Surgery UnitSanta Chiara HospitalTrento 38122Italy

BACKGROUND Radiofrequency ablation(RFA)and microwave ablation(MWA)represent the standard of care for patients with early hepatocellular carcinoma(HCC)who are unfit for surgery.The incidence of reported adverse events is low,ranging from 2.4%to 13.1%for RFA and from 2.6%to 7.5%for MWA.Gastrointestinal tract(GIT)injury is even more infrequent(0.11%),but usually requires surgery with an unfavourable prognosis.Due to its low incidence and the retrospective nature of the studies,the literature reporting this feared complication is heterogeneous and in many cases lacks information on tumour characteristics,comorbidities and treatment approaches.CASE SUMMARY A 77-year-old man who had undergone extended right hepatectomy for HCC was diagnosed with early disease recurrence with a small nodule compatible with HCC in the Sg4b segment of the liver with a subcapsular location.He was treated with percutaneous RFA and a few week later he was urgently admitted to the Surgery ward for abdominal pain and fever.A subcutaneous abscess was diagnosed and treated by percutaneous drainage.A fistulous tract was then documented by the passage of contrast material from the gastric antrum to the abdominal wall.The oesophagogastroduodenoscopy confirmed a circular wall defect at the lesser curvature of gastric antrum, leading directly to the purulentabdominal collection. An over-the-scope clip (OTSC) was used to successfullyclose the defectCONCLUSIONThis is the first reported case of RFA-related GIT injury to have been successfullytreated with an OTSC, which highlights the role of this endoscopic treatment forthe management of this complication.

关键词： Gastrointestinal tract Radiofrequency ablation Hepatocellular carcinoma Complications Endoscopy Over-the-scope clip Case report

Role of laparoscopic and robotic liver resection compared to open surgery in elderly hepatocellular carcinoma patients: a systematic review and meta-analysis

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Hepatoma Research 2020年第6期6卷 77-91页

作者： Alberto Brolese Marta Rigoni Alessandro Vitale Giovanni de pretis Ivo Avancini CeciliaPravadelli Michela Frisinghelli Umberto Rozzanigo Giacomo Luppi Francesco Dionisi Stefano Marcucci Giovanni Viel Paolo Beltempo Cristina Prezzi Marco Frisini Marco Brolese Giandomenico Nollo Francesco A.Ciarleglio department of General Surgery&HPB Unit(Chief:Alberto Brolese MD)Azienda Provinciale per i Servizi Sanitari(APSS)Santa Chiara HospitalTrento 38122Italy IRCS-Innovation and Clinical Health Research-Bruno Kessler Foundation(FBK) Trento 38123Italy department of Surgical Oncological&Gastroenterological SciencesPadua University HospitalPadua 35128Italy department of Hepatology&Gastroenterology APSSTrento 38122Italy department of Oncology Azienda Provinciale per i Servizi Sanitari(APSS)Trento 38122Italy department of Radiology Azienda Provinciale per i Servizi Sanitari(APSS)Trento 38122Italy Proton therapy Unit Azienda Provinciale per i Servizi Sanitari(APSS)Trento 38122Italy department of Industrial Engineering BIOtech LabUniversity of TrentoTrento 38122Italy School of Medicine Padua UniversityPadua 35128Italy

Aim:This study aimed to compare mini-invasive liver resection(MILR)(laparoscopic/robotic approach)and open liver resection(OLR)for hepatocellular carcinoma(HCC)in elderly patients with regard to clinical and oncological outcomes through a comprehensive systematic review.Methods:The MEDLINE and Cochrane Library electronic databases were systematically searched from 2009 to december 2019 to identify relevant English written studies comparing MILR and OLR.The main endpoints were Child-Pugh score,serum total bilirubin level,comorbidity,presence/absence of cirrhosis,minor/major resection,challenge segment approach,operative time,estimated intraoperative blood loss,liver failure rate,morbidity according to the Clavien-Dindo classification,length of hospital stay(LOS),postoperative mortality,number of lesions,tumor size,readmission rate,recurrence rate and survival at 1,3 and 5 years after operation.Meta-analyses provided pooled relative risks and mean differences for these outcomes.Cut-off for"elderly age"was set at 65 years old.Results:Eight studies that evaluated 3051 patients who underwent liver resection for HCC,with 950 undergoing MILR and 2101 OLR,were included after the screening process.Blood loss,morbidity,and LOS showed statistical significance in favor of MILR.In particular,with respect to OLR,MILR decreased on average blood loss by 161.43 mL(95%CI:250.24-72.61),risk of morbidity by 42%(Pderline liver function.MILR may be considered an important treatment option with significant benefits in the elderly a

关键词： Hepatocellular carcinoma HCC mini-invasive liver resection laparoscopic liver surgery robotic liver surgery open liver surgery meta-analysis

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在大气压下的低电感高电压火花隙中防止飞弧

真空电子技术 1974年第Z1期 5-6页

作者： M.de.pretis 郭欣增

当设计高电压的火花隙时,主要的问题是考虑产生在主绝缘子内表面的飞弧现象,飞弧主要取决于所使用的绝缘材料种类以及它的表面状况和形状。象图1的图形通常是在各种不同的状态中得到的,但是它们对于设计火花隙几乎没有实际的帮助,除非... 详细信息

当设计高电压的火花隙时,主要的问题是考虑产生在主绝缘子内表面的飞弧现象,飞弧主要取决于所使用的绝缘材料种类以及它的表面状况和形状。象图1的图形通常是在各种不同的状态中得到的,但是它们对于设计火花隙几乎没有实际的帮助,除非实验是在严格的按照同最后设想相同的状态下完成的。尽管如此,这些试验清楚地指出了聚四氟乙烯是所使用材料中最好的一种,加上它的众所周知的清洁的特性,从而保证了稳定的表面状态。对于20或30千伏的电压,聚四氟乙烯的飞弧击穿距离实际上是线性的,几乎比空气击穿距离大3倍。对于更高的电压,距离将更迅速地增大,在应用到接近100千伏的电压之后,我们看到在100毫微秒内出现大于40厘米长的飞弧。在这些情况

关键词：飞弧内表面聚四氟乙烯电弧含氟高聚物火花隙高压电高电压电阻抗电感

Partial Discharge Measurement of OCP-Tapes in Rotating Electrical Machines

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Journal of Energy and Power Engineering 2014年第8期8卷 1443-1448页

作者： Philipp pretis Jurgen Fabian Christof Sumereder Michael Muhr Helmut Heinle Christoph Richter Bernhard Brandstatter Magna Steyr AG & Co KG Fuel and Battery Systems Graz 8041 Austria Institute of Automotive Engineering Graz University of Technology Graz 8010 Austria Institute of High Voltage Engineering and System Management Graz University of Technology Graz 8010 Austria High Voltage Test Facility ELIN Motoren GmbH Preding/Weiz 8160 Austria

Nowadays, PD (partial discharge) measurements are a crucial part of the preventive maintenance of electrical equipment within high voltage engineering. Especially for electrical machines, both the supplier and the user are interested in the results of PD measurements. However, PDs hardly represent the cause of the failure, more likely they are claimed as the outcome of a failure. This paper deals with the insulation of a 6 kV electrical machine, whereas PD measurements were carried out at a single stator from wound coils. During manufacturing, these coils were equipped with different materials for the OCP (outer corona protection). Using different PD measurement systems and different bandwidths, investigations of the PD behavior of the coils were carried out. Additionally, the surface resistivity of the corona protection was determined. As a result, conclusions for the correlations between the resistance of the OCP as well as the PD behavior are stated. Furthermore, the influence of using different measurement systems, different measuring circuits, and different bandwidths is shown.

关键词：局部放电测量旋转电机电测量系统电气设备放电行为预防性维修表面电阻率高压工程