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Endoscopic therapy using a self-expandable metallic stent with an anti-migration system for postorthotopic liver transplantation anastomotic biliary stricture

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World Journal of Gastrointestinal Endoscopy 2022年第9期14卷 547-554页

作者： Larissa Wermelinger Pinheiro Fernanda Prata Martins Gustavo Andrade De Paulo Mðnica Lúcia Campos contini Angelo Paulo Ferrari Ermelindo Della Libera Department of Gastroenterology Federal University of São Paulo/Escola Paulista de MedicinaSão Paulo 04023-900Brazil Department of Endoscopy Unit Hosp Israelita Albert EinsteinSão Paulo 04042033Brazil

BACKGROUND Endoscopic therapy using multiple plastic stents(MPSs)is the standard therapy for postorthotopic liver transplantation(p-OLT)anastomotic biliary stricture(ABS).However,this approach demands repeated procedures.Recent studies us-ing fully covered self-expandable metallic stents(FCSEMS)have shown en-couraging results,but migration occurs in 10%to 40%of cases.The objective of this retrospective study was to evaluate the efficacy of endoscopic treatment using FCSEMS with an anti-migration system(Am-FCSEMS)in patients with p-OLT ABS.AIM To evaluate the efficacy of endoscopic treatment using an Am-FCSEMS in patients with p-OLT ABS.METHODS This study was conducted in a private tertiary care centre in S?o Paulo,Brazil and was approved by our institution's Human Research Committee.From April 2018 to October 2020,regardless of previous endoscopic treatment(MPS or FCSEMS),17 patients with p-OLT ABS and indications for endoscopic therapy were included in this study.The exclusion criteria were pregnancy,nonanastomotic biliary or hilar stricture,hepatic artery stenosis/thrombosis,isolated biliary fistulae,a distance shorter than 2 cm from the stricture to the hepatic hilum,and patient refusal.The primary endpoint was the efficacy of p-OLT ABS endoscopic treatment using an Am-FCSEMS that re-mained in place for a 12-mo period.Biliary sphincterotomy was performed in patients with native papilla,and an Am-FCSEMS(10 mm in final diameter and 60 or 80 mm in length)was placed(Hanarostent TM MI Tech,Co).Balloon stricture dilation was performed only if necessary to introduce the stent.RESULTS Three patients were excluded due to loss to follow-up before stent removal.Among the 14 patients included and followed,7 were women,and the average age was 56 years(range:28-76).The average period of Am-FCSEMS placement was 362±109 d.Technical success occurred in all 14 patients(100%).There were no cases of distal stent migration.Complete resolution of the stricture occurred in 13/14 patients(92.85%).Adverse events occurred in 3/14 patie

关键词： Liver transplantation Endoscopy Endoscopic retrograde cholangiopancreatography Biliary strictures Self-expandable metallic biliary stents

Typhoid intestinal perforation in developing countries: Still unavoidable deaths?

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World Journal of Gastroenterology 2017年第11期23卷 1925-1931页

作者： Sandro contini Department of Surgical Sciences University of Parma43123 ParmaItaly

Typhoid fever is a public health challenge mostly concentrated in impoverished, overcrowded areas of the developing world, with lack of safe drinking and sanitation. The most serious complication is typhoid intestinal perforation(TIP), observed in 0.8% to 39%, with a striking rate difference between high-income and low-middle-income countries. Although the mortality rate consequent to TIP in resource-poor countries is improved in the last decades, it is still fluctuating from 5% to 80%, due to surgical-and not surgical-related constraints. Huge economic costs and long timelines are required to provide a short-to middle-term solution to the lack of safe water and sanitation. Inherent limitations of the currently available diagnostic tools may lead to under-evaluation as well as over-evaluation of the disease, with consequent delayed treatment or inappropriate, excessive antibiotic use, hence increasing the likelihood of bacterial resistance. There is a need for immunization programs in populations at greatest risk, especially in sub-Saharan Africa. Uniform surgical strategies and guidelines, on the basis of sound or prospective surgical studies and adapted to the local realities, are still lacking. Major drawbacks of the surgical treatment are the frequent delays to surgery, either for late diagnosis or for difficult transports, and the unavailable appropriate intensive care units in most peripheral facilities. As a consequence, poor patient's conditions at presentation, severe peritoneal contamination and unsuitable postoperative care are the foremost determinant of surgical morbidity and mortality.

关键词： Typhoid bacterial resistance Typhoid fever Typhoid intestinal perforation Developing countries Low-Middle-Income Countries Postoperative care Typhoid vaccination

‘Diversity Culture’in Social Services:Person-Centered Care

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Journal of Sociology Study 2022年第6期12卷 254-262页

作者： Rina Manuela contini University of L’Aquila L’AquilaItaly

This article addresses the issue of‘diversity culture’in social services with the purpose of re-conceptualizing person-centered social services theory and practice.The increased participation of women,minorities,and people of different nationalities and cultures in the business world is outlining a transformation of the workforce.In parallel,there is also a diversification and heterogeneity of customers,social service users’needs,and markets and consumers’styles.The paper analyzes main groups of theories that inform social services techniques-psychological theories,cognitive behavioral theories,systemic theories,humanistic theories,and constructionist theories-with the aim of re-thinking models and practices to address the challenges that the social services are facing in responding to needs of cultural,gender,action potential,and age diversity.Specifically,social workers and the social services system are required to adapt to the changing circumstances of the social,economic,cultural and communicative environment.

关键词： diversity culture social services person-centered care diversity management

Sociological Complexity Theory:From Epistemology to Empirical Methodology

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Journal of Sociology Study 2023年第3期13卷 105-115页

作者： Rina Manuela contini University of L’Aquila L’AquilaItaly

This study,through a re-conceptualization of sociological complexity theory’s epistemological sources,specifically in Edgar Morin’s formulation,sheds light on the theoretical models as well as empirical methodologies of sociological analysis of today’s complex,interconnected,diverse and globalized society and global disorder.Complexity theory leads to a shift in perspective and a transformation of the epistemological status of social sciences with an in-depth intervention of disorder,contingency,case,singular,and non-repeatable in the sociological analysis.The notion of dialogic interplay is placed at the paradigm level and stands out at the heart of the concepts,analyzing the social system as auto-eco-organizer.Similarly,the notion of‘emergence’at macro-micro levels imposes itself as complex,logically requiring overcoming simple,linear thinking and model of explanation to adopt the perspective of organizational rotativity in which the product retroacts by transforming the one producing it,by conceiving a circularity of co-production between individuals and society through interactions.Declining epistemology and sociological complexity theory in the empirical methodology setting,the complex sociological approach is phenomenon-,event/information-and crisis-centered,privileging observation,participation-intervention,and‘live inquiry’.The open,in-depth and possibly non-directive interview is part of clinical sociological methodology,raising the question of the observer-phenomenon-observed relation.

关键词： complexity sociology theory and methodology social system emergence micro-macro analysis participation-intervention

Comparison of PM_(10) concentrations and metal content in three different sites of the Venice Lagoon: An analysis of possible aerosol sources

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Journal of Environmental Sciences 2012年第11期24卷 1954-1965页

作者： Daniele contini Franco Belosi Andrea Gambaro Daniela Cesari Angela Maria Stortini Maria Chiara Bove Institute of Atmospheric Sciences and Climate ISAC-CNRLecceItaly Institute of Atmospheric Sciences and Climate ISAC-CNRBolognaItaly Department of Environmental Sciences Informatics and StatisticsUniversity Ca'Foscari of VeniceVeneziaItaly Institute of Atmospheric Sciences and Climate ISAC-CNRLecceItaly. Institute for the Dynamics of Environmental Processes IDPA-CNRVeneziaItaly

The Venice Lagoon is exposed to atmospheric pollutants from industrial activities, thermoelectric power plants, petrochemical plants, incinerator, domestic heating, ship traffic, glass factories and vehicular emissions on the mainland. In 2005, construction began on the mobile dams （MOSE）, one dam for each channel connecting the lagoon to the Adriatic Sea as a barrier against high tide. These construction works could represent an additional source of pollutants. PM10 samples were taken on random days between 2007 and 2010 at three different sites： Punta Sabbioni, Chioggia and Malamocco, located near the respective dam construction worksites. Chemical analyses of V, Cr, Fe, Co, Ni, Cu, Zn, As, Mo, Cd, Sb, T1 and Pb in PM10 samples were performed by Inductively coupled plasma- quadrupole mass spectrometry （ICP-QMS） and results were used to identify the main aerosol sources. The correlation of measured data with meteorology, and source apportionment, failed to highlight a contribution specifically associated to the emissions of the MOSE construction works. The comparison of the measurements at the three sites showed a substantial homogeneity of metal concentrations in the area. Source apportionment with principal component analysis （PCA） and positive matrix factorization （PMF） showed that a four principal factors model could describe the sources of metals in PM10. Three of them were assigned to specific sources in the area and one was characterised as a source of mixed origin （anthropogenic and crustal）. A specific anthropogenic source of PM10 rich in Ni and Cr, active at the Chioggia site, was also identified.

关键词： MOdulo Sperimentale Elettromeccanico metals Venice Lagoon PM10 principal component analysis positive matrixfactorization

Hyperplasia vs hypertrophy in tissue regeneration after extensive liver resection

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World Journal of Gastroenterology 2017年第10期23卷 1764-1770页

作者： Fabio Marongiu Michela Marongiu Antonella contini Monica Serra Erika Cadoni Riccardo Murgia Ezio Laconi Experimental Medicine Unit Department of Biomedical SciencesUniversity of Cagliari09124 CagliariItaly

AIM To address to what extent hypertrophy and hyperplasia contribute to liver mass restoration after major tissue loss. METHODS The ability of the liver to regenerate is remarkable on both clinical and biological grounds. Basic mechanisms underlying this process have been intensively investigated. However, it is still debated to what extent hypertrophy and hyperplasia contribute to liver mass restoration after major tissue loss. We addressed this issue using a genetically tagged system. We were able to follow the fate of single transplanted hepatocytes during the regenerative response elicited by 2/3 partial surgical hepatectomy(PH) in rats. Clusters of transplanted cells were 3D reconstructed and their size distribution was evaluated over time after PH. RESULTS Liver size and liver DNA content were largely recovered 10 d post-PH, as expected(e.g., total DNA/liver/100 gb.w. was 6.37 ± 0.21 before PH and returned to 6.10 ± 0.36 10 d after PH). Data indicated that about 2/3 of the original residual hepatocytes entered S-phase in response to PH. Analysis of cluster size distribution at 24, 48, 96 h and 10 d after PH revealed that about half of the remnant hepatocytes completed at least 2 cell cycles. Average size of hepatocytes increased at 24 h(248.50 μm2 ± 7.82 μm2, P = 0.0015), but returned to control values throughout the regenerative process(up to 10 d post-PH, 197.9 μm2 ± 6.44 μm2, P = 0.11). A sizeable fraction of the remnant hepatocyte population does not participate actively in tissue mass restoration. CONCLUSION Hyperplasia stands as the major mechanism contributing to liver mass restoration after PH, with hypertrophy playing a transient role in the process.

关键词：肝新生肥大增生

Conditions for galaxy quenching at 0.5

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Research in Astronomy and Astrophysics 2020年第8期20卷 143-156页

作者： Xue Ge Feng-Shan Liu Qiu-Sheng Gu Emanuele contini Yi-Zhou Gu School of Astronomy and Space Science Nanjing UniversityNanjing 210093China Key Laboratory of Modern Astronomy and Astrophysics Nanjing UniversityNanjing 210093China Collaborative Innovation Center of Modern Astronomy and Space Exploration Nanjing 210093China Key Laboratory of Space Astronomy and Technology National Astronomical ObservatoriesChinese Academy of SciencesBeijing 100101China Department of Physics and Institute of Theoretical Physics Nanjing Normal UniversityNanjing 210023China

We investigate two classes of conditions for galaxy quenching at 0.510^10 M⊙)have much higher stellar mass surface densities within the central 1 kpc(∑1)and smaller sizes than star-forming galaxies in the same stellar mass range.In addition,the quiescent fractions significantly increase with the increase of∑1 regardless of whether galaxies are centrals or satellites.In contrast,we find that the overall lower-mass quiescent galaxies(M*<~10^10M⊙)have slightly higher E1 and comparable sizes compared to starforming galaxies of the same mass and at the same redshift.At z<1.5,satellites have higher halo masses and larger quiescent fractions than those of centrals at a given∑1(stellar mass).Our findings indicate that the significant growth of the galaxy cores is closely related to the quenching of massive galaxies since z^2.5,while the environmental effect plays an important role in the quenching of low-mass galaxies at z≤1.5.

关键词： galaxies:evolution galaxies:formation galaxies:high-redshift

Caustic injury of the upper gastrointestinal tract: A comprehensive review

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World Journal of Gastroenterology 2013年第25期19卷 3918-3930页

作者： Sandro contini Carmelo Scarpignato Department of Surgical Sciences University of Parma Clinical Pharmacology and Digestive Pathophysiology Unit Department of Clinical and Experimental Medicine University of Parma

Prevention has a paramount role in reducing the incidence of corrosive ingestion especially in children, yet this goal is far from being reached in developing countries, where such injuries are largely unreported and their true prevalence simply cannot be extrapolated from random articles or personal experience. The specific pathophysiologic mechanisms are becoming better understood and may have a role in the future management and prevention of long-term consequences, such as esophageal strictures. Whereas the mainstay of diagnosis is considered upper gastrointestinal endoscopy, computed tomography and ultrasound are gaining a more significant role, especially in addressing the need for emergency surgery, whose morbidity and mortality remains high even in the best hands. The need to perform emergency surgery has a persistent long-term negative impact both on survival and functional outcome. Medical or endoscopic prevention of stricture is debatable, yet esophageal stents, absorbable or not, show promising data. Dilatation is the first therapeutic option for strictures and bougies should be considered especially for long, multiple and tortuous narrowing. It is crucial to avoid malnutrition, especially in developingcountries where management strategies are influenced by malnutrition and poor clinical conditions. Late reconstructive surgery, mainly using colon transposition, offers the best results in referral centers, either in children or adults, but such a difficult surgical procedure is often unavailable in developing countries. Possible late development of esophageal cancer, though probably overemphasized, entails careful and long-term endoscopic screening.

关键词： Caustic ingestion Corrosive stricture Developing countries Surgical management Endoscopic management

Complexity and Sociology

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Journal of Sociology Study 2017年第7期7卷 376-387页

作者： Rina Manuela contini Rina Manuela contini Department of Management &Business Administration University of Chieti-Pescara VialePindaro 42 65127 Pescara Italy