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Transient elastography: A non-invasive tool for assessing liver fibrosis in HIV/HCV patients

World Journal of Gastroenterology 2010年第41期16卷 5225-5232页

作者： Valentina Li Vecchi Maurizio Soresi Claudia Colomba Giovanni Mazzola Pietro Colletti Maurizio Mineo paola di carlo Emanuele La Spada Giovanni Vizzini Giuseppe Montalto Department of Clinical Medicine and Emerging Pathologies University of Palermo Via del Vespro 141 90127 Palermo Italy Infectious diseases Section Department of Health Promotion Sciences University of Palermo Via del Vespro 129 90127 Palermo Italy Department of Gastroenterology and Hepatology Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IsMeTT) University of Pittsburgh Medical Center Via Tricomi 1 90127 Palermo Italy

AIM: To assess the prevalence of advanced liver fibrosis (ALF) in human immunodeficiency virus (HIV), hepatitis C virus (HCV) and HIV/HCV patients using transient elastography, and to identify factors associated with ALF. METHODS: Between September 2008 and October 2009, 71 HIV mono-infected, 57 HIV/HCV co-infected and 53 HCV mono-infected patients on regular follow-up at our Center were enrolled in this study. Alcohol intake, the main parameters of liver function, presence of HCV-RNA, HIV-RNA, duration of highly active anti-retroviraltherapy (HAART) and CD4 cell count were recorded. ALF was defined as liver stiffness (LS) ≥ 9.5 kPa. To estimate liver fibrosis (LF) a further 2 reliable biochemical scores, aspartate aminotransferase platelet ratio index (APRI) and FIB-4, were also used. RESULTS: LS values of co-infected patients were higher than in either HIV or HCV mono-infected patients (χ 2M H = 4, P dia-betes, HCV-and HIV-viremia were not significantly cor-related with LS. In addition, 20% of co-infected patients had virologically unsuccessful HAART; in 50% compliance was low, CD4+ levels were 9.5 kPa. There was no significant correlation between extent of LF and HAART exposure or duration of HAART exposure, in particular with specific dideoxynucleoside analogues. CONCLUSION: ALF was more frequent in co-infected than mono-infected patients. This result correlated with lower CD4 levels. Protectiv

关键词： Liver fibrosis Transient elastography Aspartate aminotransferase platelet ratio index FIB-4 test Fibrosis evaluation Human immunodeficiency virus infection Hepatitis C virus infection

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New approach to anal cancer:Individualized therapy based on sentinel lymph node biopsy

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World Journal of Gastroenterology 2012年第44期18卷 6349-6356页

作者： paola De Nardi Michele Carvello carlo Staudacher Surgical Department San Raffaele Scientific Institute20132 MilanItaly

Oncological treatment is currently directed toward a tailored therapy *** cell carcinoma of the anal canal could be considered a suitable platform to test new therapeutic strategies to minimize treatment *** of care for patients with anal canal cancer consists of a combination of radiotherapy and *** treatment has led to a high rate of local control and a 60% cure rate with preservation of the anal sphincter,thus replacing surgical abdominoperineal *** node metastases represent a critical independent prognostic factor for local recurrence and *** and iliac lymph nodes are usually included in the radiation field,whereas the inclusion of inguinal regions still remains controversial because of the subsequent adverse side *** lymph node biopsies could clearly identify inguinal node-positive patients eligible for therapeutic groin irradiation.A sentinel lymph node navigation procedure is reported here to be a feasible and effective method for establishing the true inguinal node status in patients suffering from anal canal *** on the results of sentinel node biopsies,a selective approach could be proposed where node-positive patients could be selected for inguinal node irradiation while node-negative patients could take advantage of inguinal sparing irradiation,thus avoiding toxic side effects.

关键词： Anal carcinomal Lymphnode metastasis Sen-tinel lymphnode Tumor staging

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A Clustering Algorithm for Planning the Integration Process of a Large Number of Conceptual Schemas

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Journal of Computer Science & Technology 2015年第1期30卷 214-224页

作者： carlo Batini: paola Bonizzoni Marco Comerio Riccardo Dondi Yuri Pirola Prancesco Salandra Department of Informatics Systems and Communication University of Milano-Bicocca Milan 20126 Italy Department of Human and Social Sciences University of Bergamo Bergamo 24129 Italy

When tens and even hundreds of schemas are involved in the integration process, criteria are needed for choosing clusters of schemas to be integrated, so as to deal with the integration problem through an efficient iterative process. Schemas in clusters should be chosen according to cohesion and coupling criteria that are based on similarities and dissimilarities among schemas. In this paper, we propose an algorithm for a novel variant of the correlation clustering approach that addresses the problem of assisting a designer in integrating a large number of conceptual schemas. The novel variant introduces upper and lower bounds to the number of schemas in each cluster, in order to avoid too complex and too simple integration contexts respectively. We give a heuristic for solving the problem, being an NP hard combinatorial problem. An experimental activity demonstrates an appreciable increment in the effectiveness of the schema integration process when clusters are computed by means of the proposed algorithm w.r.t, the ones manually defined by an expert.

关键词： conceptual schema schema integration clustering

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Liver fibrosis and tissue architectural change measurement using fractal-rectified metrics and Hurst's exponent

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World Journal of Gastroenterology 2006年第14期12卷 2187-2194页

作者： Nicola dioguardi Fabio Grizzi Barbara Franceschini paola Bossi carlo Russo Laboratori di Medicina Quantitativa Istituto Clinico Humanitas IRCCS RozzanoMilanand "Michele Rodriguez" FoundationInstitute for Quantitative Methods in MedicineMilanItaly Department of Pathology Istituto Clinico Humanitas IRCCS RozzanoMilanItaly

AIM： To provide the accurate alternative metrical means of monitoring the effects of new antiviral drugs on the reversal of newly formed collagen. METHODS： digitized histological biopsy sections taken from 209 patients with chronic C virus hepatitis with different grade of fibrosis or cirrhosis, were measured by means of a new, rapid, user-friendly, fully computeraided method based on the international system meter rectified using fractal principles. RESULTS： The following were described： geometric perimeter, area and wrinkledness of fibrosis; the collation of the Knodell, Sheuer, Ishak and METAVIR scores with fractal-rectified metric measurements; the meaning of the physical composition of fibrosis in relation to the magnitude of collagen islets; the intra- and inter-biopsy sample variability of these parameters; the ＂staging＂ of biopsy sections indicating the pathway covered by fibrosis formation towards its maximum known value; the quantitative liver tissue architectural changes with the Hurst exponent. CONCLUSION： Our model provides the first metrical evaluations of the geometric properties of fibrosis and the quantitative architectural changes of the liver tissue. The representativeness of histological sections of the whole liver is also discussed in the light of the results obtained with the Hurst coefficient.

关键词： Liver Fibrosis Cirrhosis Staging Image analysis Fractals

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Spontaneous posterior vitreous detachment:A glance at the current literature

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World Journal of Experimental Medicine 2021年第3期11卷 30-36页

作者： paola Ramovecchi carlo Salati Marco Zeppieri Department of Ophthalmology University Hospital of UdineUdine 33100Italy

Spontaneous posterior vitreous detachment(PVD)is a common age-related condition in which prevalence tends to increase with *** PVD can cause the onset of symptoms that include visual disturbances,myodesopsia and *** goal of this short review was to provide a quick glance at the important factors related to PVD based on current literature in this field,which includes incidence,symptoms,diagnosis,risk factors,and education for patients with acute symptoms,and *** take home message is that an ophthalmic examination at the onset of symptoms is of utmost importance,considering that irreversible sight-threatening complications can be prevented if diagnosed and treated promptly.

关键词： Spontaneous posterior vitreous detachment Vitreous liquefaction Photopsia Vitreal adhesion Myodesopsia Vitreoretinal traction Retinal detachment

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Epidemiology of cholangiocarcinoma

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Hepatoma Research 2022年第1期8卷 218-232页

作者： Federica Turati paola Bertuccio Eva Negri carlo La Vecchia Branch of Medical Statistics Biometryand Epidemiology“G.A.Maccacaro”Department of Clinical Sciences and Community HealthUniversity of MilanMilan 20133Italy Department of Public Health Experimental and Forensic MedicineUniversity of PaviaPavia 27100Italy Department of Humanities Pegaso Online UniversityNaples 80131Italy Department of Medical and Surgical Sciences University of BolognaBologna 40123Italy

Aim:We aimed to analyze temporal trends in mortality from intrahepatic(ICC)and extrahepatic(ECC)cholangiocarcinoma in selected countries ***:Official death certification data for ICC and ECC and populations estimates for 29 countries worldwide(17 from Europe,8 from the Americas,and 4 from Australasia)and for Hong Kong Special Administrative Region of the People’s Republic of China(SAR),from 1995 to 2018,were extracted from the World Health Organization and the Pan American Health Organization ***-standardized mortality rates were computed.A joinpoint regression analysis was ***:In both sexes,ICC mortality rates increased in most countries considered,including the USA,the UK,and Australia;in some countries,including Italy and France,the increasing trends leveled off over the most recent *** men,around 2016,the highest rates(1.7-2.3/100,000)were observed in Hong Kong SAR,Portugal,France,Spain,Australia,Austria,the UK,and Canada;Latin American countries and some eastern European countries had the lowest rates(0.2-0.8/100,000).A similar pattern was observed in women,but with lower rates(from 1.7/100,000 in Hong Kong SAR to 0.14/100,000 in Argentina).ECC mortality declined in most European and Australasian countries,but it tended to increase in *** both sexes,rates were below 1/100,000 around 2016,with the only exceptions being Japan(2.6/100,000 men and 1.2/100,000 women)and Hungary(1.5/100,000 men and 1.1/100,000 women).Conclusion:ICC mortality increased in most areas of the world,likely due to increased prevalence of risk factors and improved cancer recognition and *** mortality fell in most countries,largely due to the widespread use of cholecystectomy.

关键词： Cholangiocarcinoma mortality epidemiology temporal trends intrahepatic cholangiocarcinoma extrahepatic cholangiocarcinoma

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The effects of oral smokeless tobacco administration on endurance performance

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Journal of Sport and Health Science 2018年第4期7卷 465-472页

作者： Thomas Zandonai Enrico Tam Paolo Bruseghini Fabio Pizzolato Loretta Franceschi Massimo Baraldo carlo Capelli paola Cesari Cristiano Chiamulera Neuropsychopharmacology Laboratory Department of Diagnostic and Public HealthUniversity of VeronaVerona 37134Italy Mind Brain and Behavior Research Center CIMCYCDepartment of Experimental PsychologyUniversity of GranadaGranada 18071Spain Department of Neurosciences Biomedicine and Movement SciencesSchool of Exercise and Sport ScienceUniversity of VeronaVerona 37131Italy Department of Experimental and Clinical Medical Sciences University of UdineUdine 33100Italy Department of Physical Performances Norwegian School of Sport SciencesOslo N-0806Norway）： Corresponding author.E-mail address：thomas.zandonai@univr.itContributed equally to this manuscript.

Background： Smokeless tobacco is widely used by athletes to enhance performance. Nicotine is a central nervous system stimulant and acts on cardiocirculatory and metabolic systems, involving tissue blood flow and circulatory vasoreactivity. The aim of this study was to investigate the effects of the oral smokeless tobacco （Swedish snus （SS）） on the perception of fatigue and time to exhaustion （TTE） during moderate-intensity aerobic exercise. Methods： Fourteen healthy non-tobacco male users were recruited for a double-blind, controlled crossover design （SS vs. snus placebo （SP））. Subjects were tested for 3 sessions： experimental session 1 （Exp 1） consisted of an incremental test to determine the maximal aerobic power out-put （Wmax）, whereas Exp2 and Exp3 consisted of exercising at 65%Wmax until exhaustion in SS or SP conditions. During Exp2 and Exp3, muscle and cerebral oxygenation was assessed by means of near-infrared spectroscopy, and the rating of perceived exertion （RPE） was recorded. Results： Comparing SS with SP tests, significant differences （p 〈 0.05） were found in the values of cerebral （-3%） and muscular tissues oxygenation （-4%） in the first 30 min of exercise. The RPE values were not significantly different between the 2 conditions （SS vs. SP）. No significant difference was found in TTE （SS： 54.25 ± 21.84 min; SP： 50.01 ± 17.03 min）. Conclusion： This study showed that muscular and cerebral oxygenation increased significantly with snus administration during an endurance exercise until exhaustion, but this did not affect fatigue perception and TTE. The results showed that snus could not be considered an ergogenic substance in non-tobacco users.2018 Published by Elsevier B.V. on behalf of Shanghai University of Sport. This is an open access article under the CC BY-NC-ND license. （http：//***/licenses/by-nc-nd/4.0/）.

关键词： Exercise endurance Maximal aerobic power Nicotine RPE Smokeless tobacco Snus Time to exhaustion Tissue oxygenation

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dietary approach and gut microbiota modulation for chronic hepatic encephalopathy in cirrhosis

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World Journal of Hepatology 2019年第6期11卷 489-512页

作者： Daniela Campion Ilaria Giovo paola Ponzo Giorgio M Saracco Federico Balzola carlo Alessandria division of Gastroenterology and Hepatology Città della Salute e della Scienza di Torino Hospital University of Turin

Hepatic encephalopathy(HE)is a common and serious neuropsychiatric complication of cirrhosis,acute liver failure,and porto-systemic *** largely contributes to the morbidity of patients with liver disease,severely affecting the quality of life of both patients and their relatives and being associated with poor *** presentation is largely variable,manifesting with a broad spectrum of cognitive abnormalities ranging from subtle cognitive impairment to *** pathogenesis of HE is complex and has historically been linked with ***,in the last years,it has become evident that the interplay of multiple actors,such as intestinal dysbiosis,gut hyperpermeability,and neuroinflammation,is of crucial importance in its ***,HE can be considered a result of a dysregulated gut-liverbrain axis function,where cognitive impairment can be reversed or prevented by the beneficial effects induced by“gut-centric”therapies,such as non-absorbable disaccharides,non-absorbable antibiotics,probiotics,prebiotics,and fecal microbiota *** this context dietary modifications,by modulating the intestinal milieu,can also provide significant benefit to cirrhotic patients with *** review will provide a comprehensive insight into the mechanisms responsible for gut-liver-brain axis dysregulation leading to HE in ***,it will explore the currently available therapies and the most promising future treatments for the management of patients with HE,with a special focus on the dietary approach.

关键词： Cirrhosis Hepatic encephalopathy diet therapy Gut microbiota Leaky gut Hyperammonemia Prebiotics Probiotics Gluten-casein free diet Gut microbiota transplantation

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Enteric glial cells and their role in gastrointestinal motor abnormalities: Introducing the neuro-gliopathies

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World Journal of Gastroenterology 2007年第30期13卷 4035-4041页

作者： Gabrio Bassotti Vincenzo Villanacci Simona Fisogni Elisa Rossi paola Baronio carlo Clerici Christoph A Maurer Gieri Cathomas Elisabetta Antonelli Gastroenterology and Hepatology Section Department of Clinical and Experimental Medicine University of Perugia Italy 2nd Pathology Department Spedali Civili Brescia Italy Department of Surgery Liestal Hospital Switzerland Department of Pathology Liestal Hospital Switzerland

The role of enteric glial cells has somewhat changed from that of mere mechanical support elements, gluing together the various components of the enteric nervous system, to that of active participants in the complex interrelationships of the gut motor and inflammatory events. Due to their multiple functions, spanning from supporting elements in the myenteric plexuses to neurotransmitters, to neuronal homeostasis, to antigen presenting cells, this cell population has probably more intriguing abilities than previously thought. Recently, some evidence has been accumulating that shows how these cells may be involved in the pathophysiological aspects of some diseases. This review will deal with the properties of the enteric glial cells more strictly related to gastrointestinal motor function and the human pathological conditions in which these cells may play a role, suggesting the possibility of enteric neuro- gliopathies.

关键词： Enteric glia Glial cells Gastrointestinal motility

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Short and long-term outcomes of laparoscopic colectomy in obese patients

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World Journal of Gastroenterology 2013年第42期19卷 7405-7411页

作者： Andrea Vignali paola De Nardi Luca Ghirardelli Saverio di Palo carlo Staudacher Department of Surgery San Raffaele Scientific InstituteUniversity Vita Salute20132 MilanItaly

AIM:To investigate the impact of laparoscopic colectomy on short and long-term outcomes in obese patients with colorectal ***:A total of 98 obese(body mass index>30kg/m2)patients who underwent laparoscopic(LPS)right or left colectomy over a 10 year period were identified from a prospective institutionally approved database and manually matched to obese patients who underwent open *** were selected to match for body mass index,site of primary disease,American Society of Anesthesiologists score,and year of surgery(±3 year).The parameters analyzed included age,gender,comorbid conditions,American Society of Anaesthesiologists class,diagnosis,procedure,and duration of operation,operative blood loss,and amount of homologous blood *** rate,intra and postoperative complications as were as reoperation rate,30 d and long-term morbidity rate were also *** continuous variables,the Student’s t test was used for normally distributed data the Mann-Whitney U test for nonnormally distributed *** Pearson’sχ2tests,or the Fisher exact test as appropriate,were used for ***:Conversion to open surgery was necessary in 13 of 98 patients(13.3%).In the LPS group,operative time was 29 min longer and blood loss was 78 mL lower when compared to open colectomy(P=0.03,P=0.0001,respectively).Overall morbidity,anastomotic leak and readmission rate did not significantly differ between the two groups.A trend toward a reduction of wound complications was observed in the LPS when compared to open group(P=0.09).In the LPS group,an earlier recovery of bowel function(P=0.001)and a shorter length of stay(P=0.03)were *** a median follow-up of 62(range 12-132)mo 23patients in the LPS group and 38 in the open group experienced long-term complications(LPS vs open,P=0.03).Incisional hernia resulted to be the most frequent long-term complication with a significantly higher occurrence in the open group when compared to the lapa

关键词： Obesity Colon cancer Laparoscopy Right colectomy Left colectomy Colorectal disease

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