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Near-infrared spectroscopy in adult cardiac surgery： between conflicting results and unexpected uses

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Journal of Geriatric Cardiology 2017年第11期14卷 659-661页

作者： Antonio Nenna raffaele Barbato Salvatore Matteo Greco Giuseppe Pugliese Mario Lusini Elvio Covino Massimo Chello Department of Cardiovascular Surgery Universita Campus Bio-Medico di Roma Rome Italy

Neurological complications after cardiac surgery, rang- ing from permanent stroke to transient dysfunction, repre- sent a key issue in the management of geriatric patients. Many patients aged 70 or more have history of neurological dysfunctions, which increases the risk of complications and sequelae, Severe neurologic diseases, such as strokes, occur in up to 6% of patients undergoing cardiac surgery. Therefore, in the setting of fragile patients, prevention is more important than treatment. There are several intraop- erative mechanisms of neurological injury, such as embo- lism, inflammation, intraoperative anemia,

关键词： Acute kidney injury Aortic valve stenosis Cardiac surgery Cerebral oximetry Near infrared spectroscopy

Precision medicine in gastric cancer

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World Journal of Gastrointestinal Oncology 2019年第10期11卷 804-829页

作者： Patrizia Bonelli Antonella Borrelli Franca Maria Tuccillo Lucrezia Silvestro raffaele Palaia Franco Maria Buonaguro Molecular Biology and Viral Oncology Istituto Nazionale Tumori-IRCCS-Fondazione G PascaleNapoli 80131Italy Abdominal Medical Oncology Istituto Nazionale Tumori-IRCCS-Fondazione G PascaleNapoli 80131Italy Gastro-pancreatic Surgery Division Istituto Nazionale Tumori-IRCCS-Fondazione G PascaleNapoli 80131Italy

Gastric cancer(GC)is a complex disease linked to a series of environmental factors and unhealthy lifestyle habits,and especially to genetic *** represents the second leading cause of cancer-related deaths *** onset is subtle,and the majority of patients are diagnosed once the cancer is already *** recent years,there have been innovations in the management of advanced GC including the introduction of new classifications based on its molecular *** to new technologies such as next-generation sequencing and microarray,the Cancer Genome Atlas and Asian Cancer Research Group classifications have also paved the way for precision medicine in GC,making it possible to integrate diagnostic and therapeutic *** the objectives of the subdivision of GC into subtypes is to select patients in whom molecular targeted drugs can achieve the best results;many lines of research have been initiated to this *** phase III clinical trials,trastuzumab,anti-Erb-B2 receptor tyrosine kinase 2(commonly known as ERBB2)and ramucirumab,anti-vascular endothelial growth factor receptor 2(commonly known as VEGFR2)monoclonal antibodies,were approved and introduced into first-and second-line therapies for patients with advanced/metastatic ***,the heterogeneity of this neoplasia makes the practical application of such approaches ***,scientific progress has not been matched by progress in clinical practice in terms of significant improvements in *** continues to be low in contrast to the reduction in deaths from many common cancers such as colorectal,lung,breast,and prostate *** several target molecules have been identified on which targeted drugs can act and novel products have been introduced into experimental therapeutic protocols,the overall approach to treating advanced stage GC has not substantially ***,surgical resection with adjuvant or neoadjuvant radiotherapy and ch

关键词： Gastric cancer Molecular characterization Biomarkers Precision medicine Targeted therapy

Productivity and energy balance of forest plantation harvesting in Uganda

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Forestry Studies in China 2012年第4期14卷 276-282页

作者： Hussein BALIMUNSI Stefano GRIGOLATO Rodolfo PICCHIO Kenneth NYOMBI raffaele CAVALLI College of Agricultural and Environmental Sciences Makerere University Department of Land EnvironmentAgriculture and ForestryUniversity of Padua Department of Environmental and Forestry Technologies Engineering and SciencesTuscia University

The study evaluated the productivity and energy balance of the harvesting and the extraction of wood in plantation of exotic tree species, i.e., Pinus patula （Schiede ex Schlectendahl et Chamisso） and Cupressus lusitanica （Mill.）. The harvesting and extraction operations concerned clear-cut felling on two different types of terrain （gentle and steep terrain） and two levels of prun- ing. The results show that cutting is not affected by the terrain gradient whereas the pruning condition shows a significant effect on the delimbing operation. The productivity of cutting is evaluated at 28.1 m3.d-1 for unpruned trees and at 30.2 m3.d t for pruned trees. For the extraction phase, rolling was significantly affected by terrain conditions. On steep terrain, the gross productivity can be evaluated at 22.5 m3.d 1 for an extraction distance of 40 m, while for the same distance on gentle terrain the productivity decreases to 14.1 m3.d~. As a result, the steep terrain condition showed higher energy efficiency, suggesting that it is the more efficient system of extraction. The productivity model and the energy balance resulting from the study provide a better understanding of the variables af- fecting motor-manual cutting and rolling extraction in exotic plantations in Uganda.

关键词： exotic tree plantation energy balance harvesting productivity clear-cut felling Uganda

Deceased organ donation for transplantation: Challenges and opportunities

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World Journal of Transplantation 2016年第3期6卷 451-459页

作者： raffaele Girlanda Transplant Institute Georgetown University Hospital Organ and Tissue Advisory Committee Chair - Washington Regional Transplant Community

Organ transplantation saves thousands of lives every year but the shortage of donors is a major limiting factor to increase transplantation rates. To allow more patients to be transplanted before they die on the waitlist an increase in the number of donors is necessary. Patients with devastating irreversible brain injury, if medically suitable, are potential deceased donors and strategies are needed to successfully convert them into actual donors. Multiple steps in the process of deceased organ donation can be targeted to increase the number of organs suitable for transplant. In this review, after describing this process, we discuss current challenges and potential strategies to expand the pool of deceased donors.

关键词： Consent Eligible death Imminent brain death Organ procurement Potential organ donor

Nanoscale inhibition of polymorphic and ambidextrous lAPP amyloid aggregation with small molecules

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Nano Research 2018年第7期11卷 3636-3647页

作者： Aleksandr Kakinen Jozef Adamcik Bo Wang Xinwei Ge raffaele Mezzenga Thomas P. Davis Feng Ding Pu Chun Ke ARC Centre of Excellence in Convergent Bio-Nano Science and Technology Monash Institute of Pharmaceutical Sciences Monash University 381 Royal Parade Parkville VIC 3052 Australia Food & Soft Materials Department of Health Sciences & Technology ETH Zurich Schmelzbergstrasse 9 LFO E23 8092 Zurich Switzerland Department of Physics andAstronomy Clemson University Clemson SC29634 USA Department of Chemistry Warwick University Gibbet Hill Coventry CV4 7AL UK

Understanding how small molecules interface with amyloid fibrils at the nanoscale is of importance for developing therapeutic treatments against amyloid-based diseases. Here, we show for the first time that human islet amyloid polypeptides （LAPP） in the fibrillar form are polymorphic, ambidextrous, and possess multiple periodicities. Upon interfacing with the small molecule epigallocatechin gallate （EGCG）, IAPP aggregation was rendered off-pathway and assumed a form with soft and disordered clusters, while mature IAPP fibrils displayed kinks and branching but conserved the twisted fibril morphology. These nanoscale phenomena resulted from competitive interactions between EGCG and the IAPP amyloidogenic region, as well as end capping of the fibrils by the small molecule. This information is crucial in delineating IAPP toxicity implicated in type 2 diabetes and for developing new inhibitors against amyloidogenesis.

关键词： islet amyloid polypeptides(LAPP) fibriUization persistence length small molecule discrete moleculardynamics (DMD)simulations inhibition

Single-territory incomplete surgical revascularization improves regional wall motion of remote ventricular areas： results from a propensity-matched study

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Journal of Geriatric Cardiology 2018年第7期15卷 479-485页

作者： Cristiano Spadaccio Antonio Nenna Francesco Nappl raffaele Barbato Salvatore Matteo Greco Annunziata Nusca Luigi Sommariva Massimo Chello Department of Cardiovascular Surgery Universith Campus Bio-Medico di Roma Rome Italy Department of Cardiac Surgery Golden Jubilee National Hospital Glasgow United Kingdom Department of Cardiac Surgery Centre Cardiologique du Nord Saint Denis Paris France Department of Cardiology Universith Campus Bio-Medico di Roma Rome Italy Department of Cardiology Belcolle Hospital Viterbo ltaly

Objective Basic science studies demonstrated a general intramyocardial angiogenetic response potentially responsible for the creation of a microvascular neocapillaries network assisting myocardial function. We hypothesized that the benefit provided by the reperfusion of left anterior descending （LAD） territories and the biological angiogenetic drive triggered by the revascularization could translate in a global improvement in ventricular contractility, not restricted to the grafted area. Methods High-risk patients with multivessel coronary artery disease and preoperative wall motion abnormalities were retrospectively analyzed to compare outcomes and regional ventricular function of those who received optimal medical therapy （OMT） versus those who underwent off-pump coronary artery bypass grafting （OPCABG） and received an incomplete myocardial revascularization using left internal mammary artery （LIMA） on LAD （OPCABG group）. From January 2007 to December 2014, 206 patients （OMT, n = 136, OPCABG, n = 70） were propensity-score matched to have 70 matched pairs. Variables included in propensity score analyses were ejection fraction （EF）, left ventricular end diastolic volume （LVEDVi）, EuroSCORE II. Primary endpoint was the variation in the global wall motion score index （AWMSI） as evaluated by transthoracic echocardiography. Follow up was completed at 3 years from surgery or hospital discharge. Results Regional analysis of ventricular function revealed a regional WMSI improvement in the OPCABG group not only for LAD territories but also for non-LAD regions, associated with a reduction in the negative left ventricular ischemic remodeling, compared to patients discharged in optimal medical therapy. Global AWMSI was negative in OPCABG group （-3.4 ± 2.8%） and positive in the OMT group （5.9 ± 3.1%）, indicating a better wall motion score for OPCAB patients. Surprisingly, regional WMSI improved also in non-grafted territories in the off-pump CABG group with a delta value of -3.

关键词： Cardiac surgery Coronary artery bypass graft Incomplete revascularization Wall motion score index

Antiviral therapy for hepatitis C: Has anything changed for pregnant/lactating women?

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World Journal of Hepatology 2016年第12期8卷 557-565页

作者： Anna Maria Spera Tarek Kamal Eldin Grazia Tosone raffaele Orlando Department of Clinical Medicine and Surgery Section of Infectious Diseases University of Naples Federico II

Hepatitis C virus(HCV) affects about 3% of the world'spopulation, with the highest prevalence in individuals under 40. The prevalence in pregnant women varies with geographical distribution(highest in developing countries). Prevalence also increases in sub-populations of women at high risk for blood-transmitted infections. HCV infection in pregnancy represents a non-negligible problem. However, most of the past antiviral regimens cannot be routinely offered to pregnant or breastfeeding women because of their side effects. We briefly reviewed the issue of treatment of HCV infection in pregnant/breastfeeding women focusing on the effects of the new direct-acting antivirals on fertility, pregnancy and lactation in animal studies and on the potential risk for humans based on the pharmacokinetic properties of each drug. Currently, all new therapy regimens are contraindicated in this setting because of lack of sufficient safety information and adequate measures of contraception are still routinely recommended for female patients of childbearing potential.

关键词： Hepatitis C virus infection Breastfeeding woman Antiviral therapy Pregnancy category Directacting antivirals

Liver fibrosis in primary intestinal lymphangiectasia: An undervalued topic

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World Journal of Hepatology 2014年第9期6卷 685-687页

作者： raffaele Licinio Mariabeatrice Principi Enzo Ierardi Alfredo Di Leo Gastroenterology Unit Department of Emergency and Organ TransplantationUniversity of Bari

The relationship between primary intestinal lymphangiectasia(PIL) and liver fibrosis is an emerging topic with many obscure aspects due to the rarity of the disorder.A recent paper reported that a six-month lowfat diet improved liver *** report the case of a 17-year-old girl affected by PIL whose hepatic fibrosis progressively worsened within one year,despite dietetic *** and the previous case report describe extraordinary events,which do not allow clear-cut clinical aspects to be ***,both cases suggest that in patients with PIL,it is necessary to closely monitor liver morphology with in-depth investigations including not only ultrasonography,but also elastography.

关键词： Hepatic transient elastography Liver fibrosis Low-fat diet Primary intestinal lymphangiectasia

Corneal collagen cross-linking in patients with keratoconus from the Dresden protocol to customized solutions:theoretical basis

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International Journal of Ophthalmology(English edition) 2024年第5期17卷 951-962页

作者： Ciro Caruso Luca D’Andrea Mario Troisi Michele Rinaldi raffaele Piscopo Salvatore Troisi Ciro Costagliola Corneal Transplant Center Pellegrini HospitalVia Portamedina alla Pignasecca 41Napoli 80127Italy Eye Clinic Department of NeurosciencesReproductive and Odontostomatological SciencesUniversity of Naples Federico IINaples 80131Italy Public Health Department University of Naples Federico IINaples 80131Italy Salerno Hospital University Ophthalmologic UnitBaronissiCampania 84131Italy

Keratoconus is an ectatic condition characterized by gradual corneal thinning,corneal protrusion,progressive irregular astigmatism,corneal fibrosis,and visual *** therapeutic options regarding improvement of visual function include glasses or soft contact lenses correction for initial stages,gas-permeable rigid contact lenses,scleral lenses,implantation of intrastromal corneal ring or corneal transplants for most advanced *** keratoconus cases showing disease progression corneal collagen crosslinking(CXL)has been proven to be an effective,minimally invasive and safe *** consists of a photochemical reaction of corneal collagen by riboflavin stimulation with ultraviolet A radiation,resulting in stromal crosslinks *** aim of this review is to carry out an examination of CXL methods based on theoretical basis and mathematical models,from the original Dresden protocol to the most recent developments in the technique,reporting the changes proposed in the last 15y and examining the advantages and disadvantages of the various treatment ***,the limits of non-standardized methods and the perspectives offered by a customization of the treatment are highlighted.

关键词： corneal collagen cross linking keratoconus custom fast protocol Dresden protocol lambert-beer law Bunsen-roscoe law