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Exercise and nutrition research on longevity and quality life

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Life Research 2019年第3期2卷 119-123页

作者： pierluigi Vagali School of medical and pharmaceutical sciences experimental medicine departmentUniversity of GenoaLiguriaItaly

Social environment - demographics Italian population is quickly becoming older due to a very low birth rate and thanks to the longest life expectancy in Europe (83 years on avarage). Nevertheless, focusing on the quality of that long expected life span, we come at the bottom of this European league: 65 years old Italians can expect on average to live only another 7.5 years of life in good health. There are over 20 million Italians with a sedentary lifestyle, and more than 50% of those over 65 who do not practice any kind of physical activity [2].

关键词： Italian older lifestyle

Vitamin D receptor gene polymorphisms and hepatocellular carcinoma in alcoholic cirrhosis

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World Journal of Gastroenterology 2010年第24期16卷 3016-3024页

作者： Edmondo Falleti Davide Bitetto Carlo Fabris Annarosa Cussigh Elisabetta Fontanini Ezio Fornasiere Elisa Fumolo Sara Bignulin Sara Cmet Rosalba Minisini Mario Pirisi pierluigi Toniutto Laboratory Medicine University of Udine Department of Medical Sciences Clinical and Experimental Medical Liver Transplant UnitUniversity of Udine Department of Clinical and Ex-perimental Medicine University of Eastern Piedmont "A. Avoga-dro"

AIM: To assess the relationship between vitamin D re-ceptor (VDR) gene polymorphisms and the presence of hepatocellular carcinoma (HCC). METHODS: Two-hundred forty patients who underwent liver transplantation were studied. The etiologies of liver disease were hepatitis C (100 patients), hepatitis B (37) and alcoholic liver disease (103). A group of 236 healthy subjects served as controls. HCC in the explanted liver was detected in 80 patients. The following single nucle-otide gene polymorphisms of the VDR were investigatedby polymerase chain reaction and restriction fragment length polymorphism: FokI C>T (F/f), BsmI A>G (B/b), ApaI T>G (A/a) and TaqI T>C (T/t) (BAT). RESULTS: The frequencies of genotypes in patients without and with HCC were for FokI F/F = 69, F/f = 73, f/f = 18 and F/F = 36, F/f = 36, f/f = 8; BsmI b/b = 45, B/b = 87, B/B = 28 and b/b = 33, B/b = 35, B/B = 12; for ApaI A/A = 53, A/a = 85, a/a = 22 and A/A = 27, A/a = 38, a/a = 15; for TaqI T/T = 44, T/t = 88, t/t = 28 and T/T = 32, T/t = 38, t/t = 10. Carriage of the b/b genotype of BsmI and the T/T genotype of TaqI was signif icantly associated with HCC (45/160 vs 33/80, P < 0.05 and 44/160 vs 32/80, P < 0.05, respectively). The absence of the A-T-C protective allele of BAT was signif i-cantly associated with the presence of HCC (46/80 vs 68/160, P < 0.05). A strong association was observed between carriage of the BAT A-T-C and G-T-T haplotypes and HCC only in alcoholic liver disease (7/46 vs 12/36 vs 11/21, P < 0.002, respectively).CONCLUSION: VDR genetic polymorphisms are sig-nificantly associated with the occurrence of HCC in patients with liver cirrhosis. This relationship is more specific for patients with an alcoholic etiology.

关键词： Alcohol Hepatocellular carcinoma Liver cirrhosis Vitamin D receptor polymorphisms

Rituximab-induced IgG hypogammaglobulinemia in children with nephrotic syndrome and normal pre-treatment IgG values

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World Journal of Clinical Cases 2019年第9期7卷 1021-1027页

作者： pierluigi Marzuillo Stefano Guarino Tiziana Esposito Anna Di Sessa Sara Immacolata Orsini Daniela Capalbo Emanuele Miraglia del Giudice Angela La Manna Department of Woman Child and of General and Specialized Surgery Università degli Studi della Campania "Luigi Vanvitelli"

BACKGROUND In paediatric patients with complicated nephrotic syndrome(NS), rituximab(RTX) administration can induce persistent IgG hypogammaglobulinemia among subjects showing low basal immunoglobulin G(IgG) levels.AIM To evaluate the effect of RTX on IgG levels and infections in patients with complicated NS and normal basal IgG levels.METHODS We consecutively enrolled all patients with complicated NS and normal basal IgG levels undergoing the first RTX infusion from January 2008 to January 2016. Basal IgG levels were dosed after 6 wk of absent proteinuria and with a maximal interval of 3 mo before RTX infusion. The primary outcome was the onset of IgG hypogammaglobulinemia during the follow-up according to the IgG normal values for age [mean ± standard deviation(SD)].RESULTS We enrolled 20 patients with mean age at NS diagnosis of 4.2 ± 3.3 years. The mean age at the first RTX infusion was 10.9 ± 3.5 years. Eleven out of twenty patients(55%) developed IgG hypogammaglobulinemia. None of these patients showed severe or recurrent infections. Only one patient suffered from recurrent acute otitis media and underwent substitutive IgG infusion. Three patients undergoing only the two "starting doses" experienced normalization of IgG levels. Using Kaplan-Meier analysis, the cumulative proportion of patients free of IgG hypogammaglobulinemia was 57.8% after the first RTX dose, 51.5% after the third dose, 44.1% after the fourth dose, and 35.5% after the fifth dose.CONCLUSION RTX can induce IgG hypogammaglobulinemia in patients with pre-RTX IgG normal values. None of the treated patients showed severe infections.

关键词： Nephrotic syndrome Rituximab IgG hypogammaglobulinemia Immunoglobulin

Novel frontiers of agents for bowel cleansing for colonoscopy

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World Journal of Gastroenterology 2021年第45期27卷 7748-7770页

作者： Milena Di Leo Andrea Iannone Monica Arena Giuseppe Losurdo Maria Angela Palamara Giuseppe Iabichino pierluigi Consolo Maria Rendina Carmelo Luigiano Alfredo Di Leo Unit of Digestive Endoscopy San Paolo HospitalMilan 20090Italy Section of Gastroenterology Department of Emergency and Organ TransplantationUniversity of BariBari 70124Italy Unit of Digestive Endoscopy University of MessinaHospital"G.Martino"Messina 98121Italy

The incidence of colorectal cancer(CRC)is characterized by rapid declines in the wake of widespread screening.Colonoscopy is the gold standard for CRC screening,but its accuracy is related to high quality of bowel preparation(BP).In this review,we aimed to summarized the current strategy to increase bowel cleansing before colonoscopy.Newly bowel cleansing agents were developed with the same efficacy of previous agent but requiring less amount of liquid to improve patients’acceptability.The role of the diet before colonoscopy was also changed,as well the contribution of educational intervention and the use of adjunctive drugs to improve patients’tolerance and/or quality of BP.The review also described BP in special situations,as lower gastrointestinal bleeding,elderly people,patients with chronic kidney disease,patients with inflammatory bowel disease,patients with congestive heart failure,inpatient,patient with previous bowel resection,pregnant/lactating patients.The review underlined the quality of BP should be described using a validate scale in colonoscopy report and it explored the available scales.Finally,the review explored the possible contribution of bowel cleansing in post-colonoscopy syndrome that can be related by a transient alteration of gut microbiota.Moreover,the study underlined several points needed to further investigations.

关键词： Colonoscopy Bowel preparation Cleansing agents Polyethylene glycol Adequate cleansing Constipation

Pediatric non-alcoholic fatty liver disease and kidney function: Effect of HSD17B13 variant

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World Journal of Gastroenterology 2020年第36期26卷 5474-5483页

作者： Anna Di Sessa Giuseppina Rosaria Umano Grazia Cirillo Antonio Paride Passaro Valentina Verde Domenico Cozzolino Stefano Guarino pierluigi Marzuillo Emanuele Miraglia del Giudice Department of Woman Child and of General and Specialized SurgeryUniversitàdegli Studi della Campania Luigi VanvitelliNapoli 80138Italy Department of Internal Medicine Universitàdegli Studi della Campania Luigi VanvitelliNapoli 80138Italy

BACKGROUND Growing evidence supports a genetic link between non-alcoholic fatty liver disease(NAFLD)and chronic kidney disease(CKD).Interesting data demonstrated that both the major NAFLD risk polymorphisms such as the I148M polymorphism in the patatin like phospholipase containing domain 3(PNPLA3)and the E167K allele in the transmembrane 6 superfamily member 2 gene(TM6SF2)affect renal function.Recently the hydroxysteroid 17-beta dehydrogenase 13(HSD17B13)gene has been recognized as a novel genetic variant involved in NAFLD pathophysiology.In particular,it has been showed the protective effect of the rs72613567:TA variant of this gene against liver damage both in adults and children.AIM To investigate the impact of the rs72613567:TA variant of the HSD17B13 gene on estimated glomerular filtration rate(eGFR)in obese children.METHODS We enrolled 684 obese children(mean age 10.56±2.94 years;mean BMI-SDS 2.98±0.78)consecutively attending our Obesity Clinic.All the patients underwent a careful clinical assessment and a comprehensive biochemical evaluation.To detect hepatic steatosis,a liver ultrasound was performed.NAFLD was defined by ultrasound detected liver steatosis and/or alanine aminotransferase(ALT)levels>40 IU/L.The study population was divided on the basis of the NAFLD presence.Genotyping for the rs72613567:TA variant of the HSD17B13 gene in all the enrolled subjects was also made.RESULTS Patients carrying the HSD17B13 rare A allele showed higher eGFR levels compared with homozygous patients both among subjects with and without NAFLD.A general linear model confirmed a direct and significant association of eGFR values with HSD17B13 genotype independently of PNPLA3 and TM6SF2 polymorphisms both in patients with and without NAFLD.A comparison of regression line confirmed the influence of HSD17B13 genotype on the relationship between eGFR and age both among patients with and without NAFLD.H omozygous patients for HSD17B13 genotype with NAFLD showed a significantly higher decline of eGFR with the increase of the a

关键词： Hydroxysteroid Dehydrogenase Fatty Liver Renal Function Obese Children

Advances in paediatric nonalcoholic fatty liver disease:Role of lipidomics

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World Journal of Gastroenterology 2021年第25期27卷 3815-3824页

作者： Anna Di Sessa Simona Riccio Emilia Pirozzi Martina Verde Antonio Paride Passaro Giuseppina Rosaria Umano Stefano Guarino Emanuele Miraglia del Giudice pierluigi Marzuillo Department of Woman Childand General and Specialized SurgeryUniversity of Campania Luigi VanvitelliNaples 80138Italy

Due its close relationship with obesity,nonalcoholic fatty liver disease(NAFLD)has become a major worldwide health issue even in childhood.The most accepted pathophysiological hypothesis is represented by the“multiple hits”theory,in which both hepatic intracellular lipid accumulation and insulin resistance mainly contribute to liver injury through several factors.Among these,lipotoxicity has gained particular attention.In this view,the pathogenic role of different lipid classes in NAFLD(e.g.,sphingolipids,fatty acids,ceramides,etc.)has been highlighted in recent lipidomics studies.Although there is some contrast between plasma and liver findings,lipidomic profile in the NAFLD context provides novel insights by expanding knowledge in the intricate field of NAFLD pathophysiology as well as by suggesting innovative therapeutic approaches in order to improve both NAFLD prevention and treatment strategies.Selective changes of distinct lipid species might be an attractive therapeutic target for treating NAFLD.Herein the most recent evidence in this attractive field has been summarized to provide a comprehensive overview of the lipidomic scenario in paediatric NAFLD.

关键词： Fatty Liver Lipidomics Children Nonalcoholic fatty liver disease

Orographic Effects on Extreme Rainfall at Different Durations: A Case Study in Campania Region (Southern Italy)

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Journal of Geoscience and Environment Protection 2018年第11期6卷 77-88页

作者： pierluigi Furcolo Anna Pelosi Department of Civil Engineering University of Salerno Fisciano (SA) Italy

Long-term probabilistic prediction of extreme rainfall at the regional scale is a significant tool in the mitigation of hydro-geological disasters: it actually provides the starting point in the design of strategic hydraulic infrastructures and emergency plans. A crucial task of regional estimation of extreme rainfall is how to include the complex effects of orographic barriers in a mathematical model for Intensity-Duration-Frequency (IDF) curves. Here, an analysis of how orography can affect extreme rainfall at different durations is presented for three orographic systems that are very relevant for hydrological risk assessment in the Campania Region in Southern Italy. Then, we introduce a power law model to link the amplification factor to the duration, thus allowing a simple and effective enhancement of the IDF model in mountainous areas.

关键词： Orography Extreme Rainfall Regional Models Orographic Amplification IDF Curves

Biosystems Engineering Curricula in Europe

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Journal of Agricultural Science and Technology(A) 2013年第1期3卷 1-9页

作者： pierluigi Febo Antonio Comparetti Dipartimento dei Sistemi Agro-Ambientali Universith di Palermo Palermo 90128 ltaly

Appendicitis in children less than five years old:A challenge for the general practitioner

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World Journal of Clinical Pediatrics 2015年第2期4卷 19-24页

作者： pierluigi Marzuillo Claudio Germani Baruch S Krauss Egidio Barbi Department of Women and Children and General and Specialized Surgery Seconda Università degli Studi di Napoli Institute for Maternal and Child Health IRCCS Burlo Garofolo Boston Childrens Hospital

Acute appendicitis is one of the most common indications for abdominal surgery in pediatrics with peak incidence in the second decade of life. Acute appendicitis in the first years of life is an uncommon event. The clinical presentation is often varied and the diagnosis may be overshadowed by other medical conditions.Gastroenteritis is the most common misdiagnosis, with a history of diarrhea present in 33% to 41% of patients. Pain is the most common presenting symptom in children less than 5 years old, followed by vomiting, fever, anorexia and diarrhea. The most common physical sign is focal tenderness(61% of the patients) followed by guarding(55%), diffuse tenderness(39%), rebound(32%), and mass(6%). Neonatal appendicitis is a very rare disease with high mortality; presenting symptoms are nonspecific with abdominal distension representing the main clinical presentation. The younger the patient, the earlier perforation occurs: 70% of patients less than 3 years develop a perforation within 48 h of onset of symptoms. A timely diagnosis reduces the risk of complications. We highlight the epidemiology, pathophysiology, clinical signs and laboratory clues of appendicitis in young children and suggest an algorithm for early diagnosis.

关键词： Appendicitis Children Early diagnosis Newborn Appendicitis complications