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Long-term complete response in metastatic poorly-differentiated neuroendocrine rectal carcinoma with a multimodal approach: A case report

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World Journal of Clinical Oncology 2021年第6期12卷 500-506页

作者： Silvia Della Torre Germana de Nucci pietro maria lombardi Samuele Grandi Gianpiero Manes Roberto Bollina Oncology Unit ASST RhodenseRho 20017Italy Department of Gastroenterology Garbagnate Milanese HospitalASST RhodenseGarbagnate Milanese 20024Italy Minimally Invasive Surgery Division Niguarda HospitalMilan 20110Italy Robotic and Emergency Surgery General Surgery DivisionManzoni HospitalLecco 23900Italy Gastroenterology Unit ASST Rhodense-Garbagnate MilaneseGarbagnate Milanese 20054Italy

BACKGROUND Neuroendocrine gastrointestinal tumors(NETs)are rare and have different natural *** is the gold standard treatment for local disease while radiotherapy has been demonstrated to be *** differentiated neuroendocrine carcinomas(NECs)represent only 5%-10%of digestive *** to aggressive growth and rapid metastatic diffusion,early diagnosis and a multidisciplinary approach are *** role of surgery and radiotherapy in this setting is still debated,and chemotherapy remains the treatment of *** SUMMARY A 42-year-old male with an ulcerated bleeding rectal lesion was diagnosed with a NEC G3(Ki67 index>90%)on May 2015 and initially treated with 3 cycles of first-line chemotherapy,but showed early local progressive disease at 3 mo and underwent sphincter-sparing open anterior low rectal *** September 2015,the first post-surgery total-body computed tomography(CT)scan showed an early pelvic disease ***,systemic chemotherapy with FOLFIRI was started and the patient obtained only a partial *** was followed by pelvic radiotherapy(50 Gy).On April 2016,a CT scan and 18F-fluorodeoxy-glucose positron emission tomography imaging showed a complete response(CR)of the pelvic lesion,but pathological abdominal inter-aortocaval lymph nodes were *** to disease progression of abdominal malignant nodes,the patient received radiotherapy at 45 Gy,and finally obtained a *** of January 2021,the patient has no symptoms of relapse and no late toxicity after chemotherapy or *** This case demonstrates how a multimodal approach can be successful in obtaining long-term CR in metastatic sites in patients with high grade digestive NECs.

关键词： Neuroendocrine tumor Multimodal therapy Rectal carcinoma Surgery Radiotherapy Case report

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Indocyanine green:The guide to safer and more effective surgery

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World Journal of Gastrointestinal Surgery 2024年第3期16卷 641-649页

作者： pietro Fransvea maria Michela Chiarello Valeria Fico maria Cariati Giuseppe Brisinda Emergency Surgery and Trauma Center Fondazione Policlinico Universitario Agostino Gemelli IRCCSRome 00168Italy Department of Surgery Azienda Sanitaria Provinciale di CosenzaCosenza 87100Italy Department of Surgery Azienda Sanitaria Provinciale di CrotoneCrotone 88900Italy Department of Abdominal and Endocrine Metabolic Medical and Surgical Sciences Fondazione Policlinico Universitario A Gemelli IRCCSRome 00168Italy

In this editorial we comment on the article by Kalayarasan and co-workers published in the recent issue of the World Journal of Gastrointestinal *** authors present an interesting review on the use of indocyanine green fluo-rescence in different aspects of abdominal *** also highlight future perspectives of the use of indocyanine green in mini-invasive ***-cyanine green,used for fluorescence imaging,has been approved by the Food and Drug Administration and is safe for use in *** can be administered in-travenously or *** its advent,there have been several advance-ments in the applications of indocyanine green,especially in the surgical field,such as intraoperative mapping and biopsy of sentinel lymph node,measurement of hepatic function prior to resection,in neurosurgical cases to detect vascular anomalies,in cardiovascular cases for patency and assessment of vascular ab-normalities,in predicting healing following amputations,in helping visualization of hepatobiliary anatomy and blood vessels,in reconstructive surgery,to assess flap viability and for the evaluation of tissue perfusion following major trauma and *** these reasons,the intraoperative use of indocyanine green has become common in a variety of surgical specialties and transplant ***-lorectal surgery has just lately begun to adopt this technique,particularly for perfusion visualization to prevent anastomotic *** regular use of in-docyanine green coupled with fluorescence angiography has recently been pro-posed as a feasible tool to help improve patient *** the best available data,it has been shown that routine use of indocyanine green in colorectal surgery reduces the rates of anastomotic *** use of indocyanine green is proven to be safe,feasible,and effective in both elective and emergency ***,additional robust evidence from larger-scale,high-quality studies is essential before incorporating indocyanine g

关键词： Indocyanine green Colorectal surgery Fluorescence-guided surgery Gastrointestinal surgery Hepato-biliary surgery Pancreatic surgery Surgical oncology

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Influence of sarcopenia and frailty in the management of elderly patients with acute appendicitis

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World Journal of Clinical Cases 2024年第33期12卷 6580-6586页

作者： pietro Fransvea maria Michela Chiarello Valeria Fico maria Cariati Giuseppe Brisinda Emergency and Trauma Surgery Unit Fondazione Policlinico Universitario Agostino Gemelli IRCCSRoma 00168Italy Department of Surgery Provincial Health AuthorityCosenza 87100Italy Department of Surgery Provincial Health AuthorityCrotone 88900Italy Translational Medicine and Surgery Catholic School of MedicineRoma 00168Italy

In developed countries,the average life expectancy has been increasing and is now well over 80 *** life expectancy is associated with an increased number of emergency surgical procedures performed in later age *** appendicitis is one of the most common surgical diseases,with a lifetime risk of 8%.A growing incidence of acute appendicitis has been registered in the elderly population and in the oldest groups(>80 years).Among patients>50-year-old who present to the emergency department for acute abdominal pain,15%have acute *** these patients,emergency surgery for acute appendicitis is challenging,and some important aspects must be *** the elderly,surgical treatment outcomes are influenced by *** must be considered a precursor of frailty,a risk factor for physical function *** has a negative impact on both elective and emergency surgery regarding mortality and *** from morbidity and mortality,the most crucial outcomes for older patients requiring emergency surgery are reduction in function decline and preoperative physical function ***,prediction of function decline is *** emergency surgery,preoperative interventions are difficult to implement because of the narrow time window before *** this editorial,we highlight the unique aspects of acute appendicitis in elderly patients and the influence of sarcopenia and frailty on the results of surgical treatment.

关键词： Acute appendicitis Appendectomy Elderly Frailty Sarcopenia

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MIS 5e sea surface temperature estimation;a multi-proxy approach using a marine macrofossil assemblage(Mar Piccolo,Gulf of Taranto,Southern Italy)

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Journal of Palaeogeography 2024年第2期13卷 327-350页

作者： Pierluigi Santagati Edoardo Perri maria Pia Bernasconi Mario Borrelli Salvatore Guerrieri Salvatore Critelli Dipartimento di Biologia Ecologia e Scienze della TerraUniversita della Calabriavia Pietro Bucci87036 Arcavacata di RendeCosenzaItaly Dipartimento di Ingegneria Ambientale Universita della Calabriavia Pietro Bucci87036 Arcavacata di RendeCosenzaItaly

It is reported a multi-proxy palaeoclimatic study conducted on a MIS 5e calcarenite from the Mar Piccolo Basin(MP),Gulf of Taranto(GT)(Central Mediterranean).The calcarenite returned a rich malacofauna consisting of 120 extant species,including four of the tropical Senegalese Fauna,today absent in the *** biogeographic-climatic affinity of the assemblage shows,compared to today,a double percentage of warm affinity species,while the cold affinity species are nearly equally represented,indicating a warmer but not strictly tropical *** is confirmed by the most recurring preferred SST ranges of the assemblage,indicating an average of 20℃.The skeletal compositions of five well-preserved molluscan and coral specimens were analyzed for trace elements and stable isotopes for further mean SST *** the comparison of the results of several equations available in literature,it appears that only some SST estimations are realistic,converging into similar values of,on average,20.8±0.9℃.Considering all the used proxies,the MIS 5e SST difference compared to today falls in the range 1.2—2.0℃for the GT(being a more reasonable scenario)and 2.0—2.8℃for the *** is not a firmly tropical-like SST setting as suggested by the sole Senegalese fauna,indicating at least 2.7℃—3.5℃more than today’s GT and MP,*** approximations and assumptions made for obtaining SST values with any single proxy indicate the need of a multi-proxy approach to define the best SST estimation.

关键词： MiS 5e Sea surface temperature Palaeoclimate proxy Fossil fauna Gulf of Taranto

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Extravasated contrast volumetric assessment on computed tomography angiography in gastrointestinal bleeding:A useful predictor of positive angiographic findings

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World Journal of Radiology 2024年第5期16卷 115-127页

作者： Laura maria Cacioppa Chiara Floridi Alessandra Bruno NicolòRossini Tommaso Valeri Alessandra Borgheresi Riccardo Inchingolo Francesco Cortese Giacomo Novelli Alessandro Felicioli Mario Torresi pietro Boscarato Letizia Ottaviani Andrea Giovagnoni Division of Interventional Radiology Department of Radiological SciencesUniversity Politecnica Delle MarcheAncona 60126Italy Department of Clinical Special and Dental SciencesUniversity Politecnica Delle MarcheAncona 60126Italy Division of Radiology Department of Radiological SciencesUniversity Hospital"Azienda Ospedaliero Universitaria Delle Marche"Ancona 60126Italy Interventional Radiology Unit "F Miulli"Regional General HospitalAcquaviva delle Fonti 70021Italy Department of Radiology IRCCS INRCAAncona 60126Italy

BACKGROUND Gastrointestinal bleeding(GIB)is a severe and potentially life-threatening condition,especially in cases of delayed *** tomography angiography(CTA)plays a pivotal role in the early identification of upper and lower GIB and in the prompt treatment of the *** To determine whether a volumetric estimation of the extravasated contrast at CTA in GIB may be a predictor of subsequent positive angiographic *** In this retrospective single-centre study,35 patients(22 men;median age 69 years;range 16-92 years)admitted to our institution for active GIB detected at CTA and further submitted to catheter angiography between January 2018 and February 2022 were ***-three(65.7%)patients underwent endoscopy before *** volumetry was evaluated in both arterial and venous phases via a semi-automated dedicated *** rate was obtained from volume change between the two phases and standardised for unit *** were divided into two groups,according to the angiographic signs and their concordance with *** Upper bleeding accounted for 42.9%and lower GIB for 57.1%.Mean haemoglobin value at the admission was 7.7 g/dL.A concordance between positive CTA and direct angiographic bleeding signs was found in 19(54.3%)*** no significant differences in terms of bleeding volume in the arterial phase(0.55 mL vs 0.33 mL,P=0.35),a statistically significant volume increase in the venous phase was identified in the group of patients with positive angiography(2.06 mL vs 0.9 mL,P=0.02).In the latter patient group,a significant increase in bleeding rate was also detected(2.18 mL/min vs 0.19 mL/min,P=0.02).CONCLUSION In GIB of any origin,extravasated contrast volumetric analysis at CTA could be a predictor of positive angiography and may help in avoiding further unnecessary procedures.

关键词： Gastrointestinal haemorrhage Computed tomography angiography Volumetric analysis Computer-assisted image interpretation Therapeutic embolization Transcatheter arterial embolization

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Impact of pre-existing cardiometabolic diseases on metastatic cancer stage at diagnosis:a prospective multinational cohort study

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Cancer Communications 2024年第5期44卷 593-597页

作者： Anna Jansana Aviane Auguste Marina Kvaskoff Agnès Fournier Emma Fontvieille Laia Peruchet-Noray Carine Biessy Reynalda Cordova Kristina Elin Nielsen Petersen Anne Tjoneland Verena Katzke Rudolf Kaaks Fulvio Ricceri Salvatore Panico Paolo Contiero maria-Jose Sánchez Jesus Castilla Marta Crous-Bou Alicia Heath Elom Kouassivi Aglago Elisabete Weiderpass Marc James Gunter pietro Ferrari Elio Riboli Vivian Viallon Heinz Freisling International Agency for Research on Cancer(IARC-WHO) LyonFrance Paris-Saclay University University of Versailles-Saint-Quentin-en-YvelineUniversity Paris-SudFrench National Institute for Health and Medical Research(Inserm)Gustave Roussy“Exposome and Heredity”TeamCESPVillejuifFrance Department of Nutritional Sciences University of ViennaViennaAustria Danish Cancer Society Research Center CopenhagenDenmark Department of Public Health University of CopenhagenCopenhagenDenmark Division of Cancer Epidemiology German Cancer Research CentreHeidelbergGermany Department of Clinical and Biological Sciences University of TurinTurinItaly Unit of Epidemiology Regional Health Service ASL TO3GrugliascoTurinItaly Department of Clinical Medicine and Surgery Federico II UniversityNaplesItaly Environmental Epidemiology Unit Istituto di Ricovero e Cura a Carattere Scientifico(IRCCS)-Istituto Nazionale dei TumoriMilanItaly Cancer Registry of Granada Institute for Biosanitary Research of Granada(ibs.GRANADA)GranadaSpain Epidemiology and Control of Chronic Diseases Group Epidemiology and Public Health Networking Biomedical Research CentreMadridSpain Navarra Public Health Institute PamplonaSpain Unit of Nutrition and Cancer Cancer Epidemiology Research ProgramCatalan Institute of Oncology(ICO)-Bellvitge Biomedical Research Institute(IDIBELL)L’Hospitalet de LlobregatBarcelonaSpain Department of Epidemiology Harvard Tseng-Hsi Chan School of Public HealthBostonMassachusettsUSA Department of Epidemiology and Biostatistics School of Public HealthImperial College LondonSt Mary’s CampusNorfolk PlaceLondonUK

Owing to shared risk factors between cardiometabolic diseases(CMDs)and cancer,coupled with population aging,the lifetime risk of an individual developing cancer after a CMD is ***,biological mechanisms such as insulin resistance or inflammation may not only predispose individuals withCMDto an elevated risk of certain types of cancer but also to a diagnosis of cancer at an advanced stage[1,2].

关键词： diagnosis diseases cancer

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Solid pseudopapillary tumor of the pancreas:A systematic review of clinical,surgical and oncological characteristics of 1384 patients underwent pancreatic surgery

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Hepatobiliary & Pancreatic Diseases International 2024年第4期23卷 331-338页

作者： Gennaro Mazzarella Edoardo maria Muttillo Diego Coletta Biagio Picardi Stefano Rossi Simone Rossi Del Monte Vito Gomes Irnerio Angelo Muttillo Division of General and Emergency Surgery San Filippo Neri Hospital00136 RomeItaly Department of Surgery“pietro Valdoni” Sapienza University of RomeViale del Policlinico 15500161 RomeItaly Surgical and Medical Department of Translational Medicine Sant’Andrea HospitalSapienza University of Rome00185 RomeItaly Department of Surgical Sciences Umberto I University HospitalSapienza University of Rome00136 RomeItaly Department of General Surgery Ospedali Riuniti Marche Nord61121 PesaroItaly Department of Pathology San Filippo Neri Hospital00136 RomeItaly

Background:Pancreatic solid pseudopapillary tumors(SPTs)are rare clinical entity,with low malignancy and still unclear *** account for less than 2%of exocrine pancreatic *** study aimed to perform a systematic review of the main clinical,surgical and oncological characteristics of pancreatic *** sources:MEDLINE/PubMed,Web of Science and Scopus databases were systematically searched for the main clinical,surgical and oncological characteristics of pancreatic SPTs up to April 2021,in accordance with the preferred reporting items for systematic reviews and meta-analyses(PRISMA)*** endpoints were to analyze treatments and oncological ***:A total of 823 studies were recorded,86 studies underwent full-text reviews and 28 met inclusion ***,1384 patients underwent pancreatic *** age was 30 years and 1181 patients(85.3%)were *** most common clinical presentation was non-specific abdominal pain(52.6%of cases).Mean overall survival was 98.1%.Mean recurrence rate was 2.8%.Mean follow-up was 4.2 ***:Pancreatic SPTs are rare,and predominantly affect young women with unclear *** resection is the gold standard of treatment achieving good oncological impact and a favorable prognosis in a yearly life-long follow-up.

关键词： Frantz’s tumor Pancreas Pancreatic neoplasms Pancreatic surgery Solid pseudopapillary tumor

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Influence of dietary hydrogenated palm oil supplementation on serum biochemistry and progesterone levels in dairy goats

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Animal Nutrition 2019年第3期5卷 286-289页

作者： Raffaella Tudisco Nadia Musco maria E.Pero Valeria M.Morittu Micaela Grossi Vincenzo Mastellone Gina Cavaliere Metha Wanapat Federico Infascelli pietro lombardi Department of Veterinary Medicine and Animal Production University of Naples Federico IINapoli80137Italy Department of Health Science University Magna Graecia of CatanzaroCatanzaro88100Italy Department of Biology University of Naples Federico IINapoli80134Italy Tropical Feed Resources Research and Development Center(TROFREC) Department of Animal ScienceFaculty of AgricultureKhon Kaen UniversityKhonKaen40260Thailand

The aim of this research was to investigate the influence of hydrogenated palm oil(HPO)added to a dairy goat diet on serum biochemistry and progesterone *** pregnant Cilentana dairy goats were equally divided into 2 groups(control [CTR]and HPO groups).After kidding,concentrated feed for both groups was gradually increased up to 400 g/(animal d).and the HPO group received 50 g/(animal·d)of *** with HPO significantly increased cholesterol levels(mg/dL, 63.80 vs.54.68 at 30 d.P<0.05;78.20 vs.58.00 at 60 d.P<0.05;83.80 vs.57.83 at 120 d.P<0.01)compared with the CTR group although no significant differences were detected for liver and kidney function ***,other biochemical parameters were not affected by HPO supplementation thus suggesting no change occurred in lipid and protein ***,a significant correlation was found between progesterone levels and serum cholesterol(r = 0.65,P≤0.01)although these were not significantly higher in HPO supplemented *** dose and time of HPO supplementation appears critical as regards assessing the limits between the risks and benefits of HPO supplementation in dairy *** the tested *** was well tolerated by the animals and may represent a useful tool to increase energy availability during highly demanding periods.

关键词： Goat Hydrogenated palm oil Metabolism Progesterone

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Endoluminal vacuum-assisted therapy as a treatment for anastomotic leakage in colorectal surgery

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World Journal of Gastroenterology 2022年第28期28卷 3747-3752页

作者： maria Michela Chiarello Valentina Bianchi pietro Fransvea Giuseppe Brisinda Department of Surgery Azienda Sanitaria Provinciale di CosenzaCosenza 87100Italy Emergency Surgery and Trauma Center Fondazione Policlinico Universitario A Gemelli IRCCSRome 00168taly Medical and Surgical Sciences Fondazione Policlinico Universitario A Gemelli IRCCSRome 00168Italy

Anastomotic leakage(AL)has a wide range of clinical features ranging from radiological only findings to peritonitis and sepsis with multiorgan *** early diagnosis of AL is essential in order to establish the most appropriate treatment for this *** AL continues to be a dreadful complication after colorectal surgery,there has been no consensus on its ***,based on patient’s presentation and timing of the AL,there has been a gradual shift to a more conservative management,keeping surgery as the last option Reoperation for sepsis control is rarely necessary especially in those patients who already have a diverting stoma at the time of the leak.A nonoperative management is usually preferred in these *** are several treatment options,also for patients without a stoma who do not require a reoperation for a contained pelvic leak,including recently developed endoscopic procedures,such as clip placement or endoluminal vacuum-assisted *** conservative treatments could be an option in patients who are clinically stable or in presence of a small defect.

关键词： Anastomotic leakage Colorectal cancer Colorectal surgery Mortality Morbidity

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Clinical features and management of primary biliary cirrhosis

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World Journal of Gastroenterology 2008年第21期14卷 3313-3327页

作者： Andrea Crosignani Pier maria Battezzati pietro Invernizzi Carlo Selmi Elena Prina Mauro Podda Division of Internal Medicine and Liver Unit San Paolo Hospital School of MedicineUniversity of MilanMilano 20142Italy Division of Internal Medicine and Liver Unit San Paolo Hospital School of MedicineUniversity of MilanMilano 20142Italy Division of RheumatologyAllergyand Clinical ImmunologyUniversity of California at DavisDavisCA 95616United States

Primary biliary cirrhosis(PBC),which is characterised by progressive destruction of intrahepatic bile ducts,is not a rare disease since both prevalence and incidence are increasing during the last years mainly due to the improvement of case finding *** prognosis of the disease has improved due to both the recognition of earlier and indolent cases,and to the wide use of ursodeoxycholic acid(UDCA).New indicators of prog-nosis are available that will be useful especially for the growing number of patients with less severe *** patients are asymptomatic at ***-tus may represent the most distressing symptom and,when UDCA is ineffective,cholestyramine represents the mainstay of *** of long-standing cholestasis may be clinically relevant only in very ad-vanced *** data on the effects of UDCA on clinically relevant end points clearly indicate that the drug is able to slow but not to halt the progression of the disease while,in advanced stages,the only thera-peutic option remains liver transplantation.

关键词： Primary biliary cirrhosis Epidemiology Clinical course Natural history Treatment

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