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Trends of autoimmune liver disease inpatient hospitalization and mortality from 2011 to 2017:A United States nationwide analysis

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World Journal of Hepatology 2024年第7期16卷 1029-1038页

作者： Ali Wakil Yasameen Muzahim Mina Awadallah Vikash Kumar Natale mazzaferro Patricia Greenberg Nikolaos Pyrsopoulos Department of Gastroenterology and Hepatology The Brooklyn Hospital CenterBrooklynNY 11201United States Department of Gastroenterology and Hepatology University of Iowa Hospitals and ClinicsIowa CityIA 52242United States Department of Gastroenterology and Hepatology Rutgers the New Jersey Medical SchoolNewarkNJ 07103United States Department of Biostatistics and Epidemiology Rutgers School of Public HealthPiscatawayNJ 08854United States

BACKGRoUND Autoimmune liver diseases(AiLD)encompass a variety of disorders that target either the liver cells(autoimmune hepatitis,AIH)or the bile ducts[primary biliary cholangitis(PBC),and primary sclerosing cholangitis(PSC)].These conditions can progress to chronic liver disease(CLD),which is characterized by fibrosis,cirrhosis,and hepatocellular *** studies have indicated a rise in hospitalizations and associated costs for CLD in the US,but information regarding inpatient admissions specifically for AiLD remains *** To examine the trends and mortality of inpatient hospitalization of AiLD from 2011 to *** This study is a retrospective analysis utilizing the National Inpatient Sample(NIS)*** subjects admitted between 2011 and 2017 with a diagnosis of AiLD(AIH,PBC,PSC)were identified using the International Classification of Diseases(ICD-9)and ICD-10 *** AiLD admission was defined if the first admission code was one of the AiLD *** AiLD admission was defined as having the AiLD diagnosis anywhere in the admission diagnosis(25 diagnoses).Subjects aged 21 years and older were *** national estimates of hospitalization were derived using sample weights provided by NIS.χ^(2)tests for categorical data were *** primary trend characteristics were in-hospital mortality,hospital charges,and length of *** From 2011 to 2017,hospitalization rates witnessed a significant decline,dropping from 83263 admissions to 74850 admissions(Pents hospitalized were predominantly elderly(median 53%for age>65),mostly female(median 59%)(Por insurance(median 56%),followed by private payer(median 27%)(Pouth was the top geographical distribution for these admissions(median 33%)(Post admissions taking place in big teaching institutions(median 63%)(Potal charges for admissions rose from 66031 in 2011

关键词： Autoimmune hepatitis Autoimmune liver disease Epidemiology Cost-Effective care Admissions trend Mortality rate

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The SIRvenIB and SARAH trials, radioembolization vs. sorafenib in advanced HCC patients: reasons for a failure, and perspectives for the future

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Hepatobiliary Surgery and Nutrition 2018年第6期7卷 487-489页

作者： Carlo Sposito vin.en.o mazzaferro Department of Gastrointestinal Surgery and Liver Transplantation Fondazione IRCCS Istituto Nazionale Tumori di MilanoMilanItaly University of Milan MilanItaly

Liver cancer is the fifth most common cancer and the second most frequent cause of cancer-related death *** carcinoma(HCC)represents nearly 90%of primary liver cancers,and constitutes a major health problem worldwide(1).When diagnosed at an early stage of the disease,HCC may benefit from potentially curative treatments such as liver resection,liver transplantation or local *** effectiveness of treatment in early and very early stages,most patients are diagnosed or progress to an intermediate or advanced stage,in which treatment options are limited and the prognosis is poor(2).

关键词： patients Liver treatment

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Supramolecular hybrid hydrogels as rapidly on-demand dissoluble,self-healing,and biocompatible burn dressings

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Bioactive Materials 2023年第7期25卷 415-429页

作者： A.Aslihan Gokaltun Letao Fan Luca mazzaferro Delaney Byrne Martin L.Yarmush Tianhong Dai Ayse Asatekin o.Berk Usta Center for engineering in Medicine and Surgery Massachusetts General HospitalHarvard Medical School55 Fruit St.BostonMA02114USA Shriners Hospitals for Children 51 Blossom St.BostonMA02114USA Department of Chemical and Biological engineering Tufts University4 Colby St.MedfordMA02474USA Department of Chemical engineering Hacettepe University06532BeytepeAnkaraTurkey Department of Biomedical engineering Rutgers University599 Taylor Rd.PiscatawayNJ08854USA Wellman Center for Photomedicine Massachusetts General HospitalDepartment of DermatologyHarvard Medical School50 Blossom StreetBostonMA02114USA

Despite decades of efforts,state-of-the-art synthetic burn dressings to treat partial-thickness burns are still far from *** dressings adhere to the wound and necessitate *** work describes the first“supramolecular hybrid hydrogel(SHH)”burn dressing that is biocompatible,self-healable,and on-demand dissoluble for easy and trauma-free removal,prepared by a simple,fast,and scalable *** SHHs leverage the interactions of a custom-designed cationic copolymer via host-guest chemistry with cucurbit[7]uril and electrostatic interactions with clay nanosheets coated with an anionic polymer to achieve enhanced mechanical properties and fast on-demand *** SHHs show high mechanical strength(>50 kPa),self-heal rapidly in~1 min,and dissolve quickly(4-6 min)using an amantadine hydrochloride(AH)solution that breaks the supramolecular interactions in the *** the SHHs nor the AH solution has any adverse effects on human dermal fibroblasts or epidermal keratinocytes in *** SHHs also do not elicit any significant cytokine response in ***,in vivo murine experiments show no immune or inflammatory cell infiltration in the subcutaneous tissue and no change in circulatory cytokines compared to sham ***,these SHHs present excellent burn dressing candidates to reduce the time of pain and time associated with dressing changes.

关键词： Supramolecular hybrid hydrogels Cationic copolymer on-demand dissoluble Self-healable Biocompatible Burn injury

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Gastrinoma and Zollinger Ellison syndrome:A roadmap for the management between new and old therapies

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World Journal of Gastroenterology 2021年第35期27卷 5890-5907页

作者： Roberta Elisa Rossi Alessandra Elvevi Davide Citterio Jorgelina Coppa Pietro Invernizzi vin.en.o mazzaferro Sara Massironi HPB Surgery Hepatology and Liver TransplantationENETS Center of ExcellenceFondazione IRCCS Istituto Nazionale Tumori(INTNational Cancer Institute)Milan 20133Italy Department of Pathophysiology and Transplantation University of MilanMilan 20122Italy Division of Gastroenterology and Center for Autoimmune Liver Diseases Department of Medicine and SurgeryUniversity of Milano-BicoccaMonza 20900Italy European Reference Network on Hepatological Diseases(ERN RARE-LIVER) San Gerardo HospitalMonza 20033Italy Department of oncology and Hemato-oncology University of MilanMilan 20122Italy

Zollinger-Ellison syndrome(ZES)associated with pancreatic or duodenal gastrinoma is characterized by gastric acid hypersecretion,which typically leads to gastroesophageal reflux disease,recurrent peptic ulcers,and chronic *** symptoms of ZES are nonspecific and overlap with other gastrointestinal disorders,the diagnosis is often delayed with an average time between the onset of symptoms and final diagnosis longer than 5 *** critical step for the diagnosis of ZES is represented by the initial clinical *** is the hallmark of ZES;however,hypergastrinemia might recognize several causes,which should be ruled out in order to make a final *** levels>1000 pg/mL and a gastric pH below 2 are considered to be diagnostic for gastrinoma;some specific tests,including esophageal pH-recording and secretin test,might be useful in selected cases,although they are not widely *** ultrasound is very useful for the diagnosis and the local staging of the primary tumor in patients with ZES,particularly in the setting of multiple endocrine neoplasia type *** controversies about the management of these tumors also *** the localized stage,the combination of proton pump inhibitory therapy,which usually resolves symptoms,and surgery,whenever feasible,with curative intent represents the hallmark of gastrinoma *** high expression of somatostatin receptors in gastrinomas makes them highly responsive to somatostatin analogs,supporting their use as anti-proliferative agents in patients not amenable to surgical *** medical options for advanced disease are super-imposable to other neuroendocrine neoplasms,and studies specifically focused on gastrinomas only are scant and often limited to case reports or small retrospective *** multidisciplinary approach remains the cornerstone for the proper management of this composite ***,we reviewed available literature about gastrinoma-associated ZES wit

关键词： Gastrinoma Zollinger-Ellison syndrome Neuroendocrine neoplasms Pancreatic neuroendocrine neoplasm Duodenal neuroendocrine neoplasm Diagnosis Therapy

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Therapeutic strategies for post-transplant recurrence of hepatocellular carcinoma

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World Journal of Gastroenterology 2022年第34期28卷 4929-4942页

作者： Carlo Sposito Davide Citterio Matteo Virdis Carlo Battiston Michele Droz Dit Busset Maria Flores vin.en.o mazzaferro HPB Surgery Hepatology and Liver TransplantationFondazione IRCCS Istituto Nazionale Tumori di MilanoMilan 20133Italy Department of oncology and Hemato-oncology University of MilanMilan 20100Italy

Despite stringent selection criteria,hepatocellular carcinoma recurrence after liver transplantation(LT)still occurs in up to 20%of cases,mostly within the first 2–3 *** adjuvant treatments to prevent such an occurrence have been developed so ***,a balanced use of immunosuppression with minimal dose of calcineurin inhibitors and possible addition of mammalian target of rapamycin inhibitors is strongly ***,several pre-and posttransplant predictors of recurrence have been identified and may help determine the frequency and duration of post-transplant *** recurrence occurs,the outcomes are poor with a median survival of 12 mo according to most retrospective *** factor that most impacts survival after recurrence is timing(within 1–2 years from LT according to different authors).Several therapeutic options may be chosen in case of recurrence,according to timing and disease *** treatment seems to provide a survival benefit,especially in case of late recurrence,while the benefit of locoregional treatments has been suggested only in small retrospective *** systemic treatment is indicated,sorafenib has been proved safe and effective,while only few data are available for lenvatinib and regorafenib in second *** use of immune checkpoint inhibitors is controversial in this setting,given the safety warnings for the risk of acute rejection.

关键词： Liver transplantation Hepatocellular carcinoma Immunosuppression Recurrence Surgical treatment Locoregional treatment Systemic treatment

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Competing risk analysis on outcome after hepatic resection of hepatocellular carcinoma in cirrhotic patients

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World Journal of Gastroenterology 2017年第8期23卷 1469-1476页

作者： Alessandro Cucchetti Carlo Sposito Antonio Daniele Pinna Davide Citterio Matteo CesconMarco Bongini Giorgio Ercolani Christian Cotsoglou Lorenzo Maroni vin.en.o mazzaferro Department of Medical and Surgical Sciences DIMECS.Orsola-Malpighi HospitalAlma Mater StudiorumUniversity of Bologna Gastrointestinal Surgery and Liver Transplantation Fondazione IRCCS Istituto Nazionale Tumori(National Cancer Institute

To investigate death for liver failure and for tumor recurrence as competing events after hepatectomy of hepatocellular *** from 864 cirrhotic Child-Pugh class A consecutive patients, submitted to curative hepatectomy (1997-2013) at two tertiary referral hospitals, were used for competing-risk analysis through the Fine and Gray method, aimed at assessing in which circumstances the oncological benefit from tumour removal is greater than the risk of dying from hepatic decompensation. To accomplish this task, the average risk of these two competing events, over 5 years of follow-up, was calculated through the integral of each cumulative incidence function, and represented the main comparison *** a median follow-up of 5.6 years, death was attributable to tumor recurrence in 63.5%, and to liver failure in 21.2% of cases. In the first 16 mo, the risk of dying due to liver failure exceeded that of dying due to tumor relapse. Tumor stage only affects death from recurrence; whereas hepatitis C infection, Model for end-stage Liver Disease score, extent of hepatectomy and portal hypertension influence death from liver failure (P ombination of these clinical and tumoral features identifies those patients in whom the risk of dying from liver failure did not exceed the tumour-related mortality, representing optimal surgical candidates. It also identifies those clinical circumstances where the oncological benefit would be borderline or even where the surgery would be *** knowledge of these competing events can be used to weigh the risks and benefits of hepatic resection in each clinical circumstance, separating optimal from non-optimal surgical candidates.

关键词： Hepatocellular carcinoma Liver failure Hepatic resection Survival Competing risk Tumour recurrence

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Helicobacter species sequences in liver samples from patients with and without hepatocellular carcinoma

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World Journal of Gastroenterology 2004年第4期10卷 598-601页

作者： RinaldoPellicano MarioRizzetto AntonioPonzetto vin.en.o mazzaferro Walter Franco Grigioni MiguelAngelCutufia SharmilaFagoonee LorenzoSilengo Department of Gastro-Hepatology Ospedale S. Giovanni Battista(Molinette)TorinoItaly Surgery and Liver Transplantation Centre Istituto Nazionale dei TumoriMilanoItaly Department of Pathology Istituto AddariiBolognaItaly Department of Biology Biochemistry and GeneticsUniversity of TodnoItaly

AIM:only a minority of patients carrying a defined viral aetiologic agent develop cirrhosis and ultimately hepatocellular carcinoma(HCC),the mechanism underlying the worsening is still *** infection by Helicobacter hepaticus in mice causes chronic hepatitis and HCC and recently,more Helicobacterspecies(Helicobacter spp.)have been detected in the liver of patients suffering from cholestatic diseases and HCC arising from non-cirrhotic *** investigated whether *** could be detected in the liver of patients with cirrhosis and HCC compared to subjects with metastasis to liver from colon cancer. METHoDS:Twenty-three liver samples from patients operated upon for HCC superimposed on hepatitis C virus (HCV)-related cirrhosis and 6 from patients with resected metastases from colorectal cancer,were tested by polymerase chain reaction for presence of genomic 16S rRNA of Helicobacter genus using specific *** sequencing and cag A gene analysis were also performed. RESULTS:Genornic sequences of Helicobacter *** found in 17 of 20(85%)liver samples from patients with HCC and in 2 of 6 samples from patients with liver metastasis. In three samples of the first group the result was uncertain. Hpyloriwas revealed in 16 out of 17 positive samples and Helicobacter pullorum in the other. CoNCLUSIoN:Helicobacter spp.,carcinogenic in mice, were found at a higher frequency in the liver of patients with HCV-related cirrhosis and HCC than those in patients without primary liver disease.

关键词： Carcinoma, Hepatocellular Colonic Neoplasms DNA, Bacterial Helicobacter Infections Helicobacter pylori purification Humans Liver Cirrhosis Liver Neoplasms Research Support, Non-U.S. Gov't

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one size does not fit all for pancreatic cancers: A review on rare histologies and therapeutic approaches

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World Journal of Gastrointestinal oncology 2020年第8期12卷 833-849页

作者： Monica Niger Michele Prisciandaro Maria Antista Melissa Anna Teresa Monica Laura Cattaneo Natalie Prinzi Sara Manglaviti Federico Nichetti Marta Brambilla Martina Torchio Francesca Corti Sara Pusceddu Jorgelina Coppa vin.en.o mazzaferro Filippo de Braud Maria Di Bartolomeo Medical oncology Department Fondazione IRCCS Istituto Nazionale dei TumoriMilan 20133Italy First Pathology Division Department of Pathology and Laboratory MedicineFondazione IRCCS Istituto Nazionale dei TumoriMilan 20133Italy Hepato-biliary-pancreatic Surgery and Liver Transplantation Department Fondazione IRCCS Istituto Nazionale dei TumoriMilan 20133Italy Universitàdegli studi di Milano Milan 20133Italy

Exocrine pancreatic neoplasms represent up to 95%of pancreatic cancers(PCs)and are widely recognized among the most lethal solid cancers,with a very poor 5-year survival rate of 5%-10%.The remainingof PCs are neuroendocrine tumors that are usually characterized by a better prognosis,with a median overall survival of 3.6 *** most common type of PC is pancreatic ductal adenocarcinoma(PDAC),which accounts for roughly 85%of all exocrine *** up to 10%of exocrine PCs have rare histotypes,which are still poorly *** subtypes can be distinguished from PDAC in terms of pathology,imaging,clinical presentation and ***,due to their rarity,any knowledge regarding these specific histotypes is mostly based on case reports and a small series of retrospective ***,treatment strategies are generally deduced from those used for PDAC,even if these patients are often excluded or not clearly represented in clinical trials for *** these reasons,it is essential to collect as much information as possible on the management of PC,as assimilating it with PDAC may lead to the potential mistreatment of these ***,we report the most significant literature regarding the epidemiology,typical presentation,possible treatment strategies,and prognosis of the most relevant histotypes among rare PCs.

关键词： Rare pancreatic cancers Pancreatic acinar cell cancer Pancreatic adenosquamous cancer Undifferentiated pancreatic cancer Pancreatoblastoma Pseudopapillary pancreatic cancer

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Development of a prognostic scoring system for resectable hepatocellular carcinoma

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World Journal of Gastroenterology 2016年第36期22卷 8194-8202页

作者： Carlo Sposito Stefano Di Sandro Federica Brunero vin.en.o Buscemi Carlo Battiston Andrea Lauterio Marco Bongini Luciano De Carlis vin.en.o mazzaferro Gastrointestinal Surgery and Liver Transplantation Fondazione IRCCS Istituto Nazionale Tumori University of Milan General Surgery and organ Transplants Ospedale Niguarda Ca’Granda20133 Milan Italy Clinical Trial office and Biomedical Statistic Fondazione IRCCS Istituto Nazionale Tumori

AIM To develop a prognostic scoring system for overall survival(oS) of patients undergoing liver resection(LR) for hepatocellular carcinoma(HCC).METHoDS Consecutive patients who underwent curative LR for HCC between 2000 and 2013 were identified. The series was randomly divided into a training and a validation set. A multivariable Cox model for oS was fitted to the training set. The beta coefficients derived from the Cox model were used to define a prognostic scoring system for oS. The survival stratification was then tested, and the prognostic scoring system was compared with the European Association for the Study of the Liver(EASL)/American Association for the Study of Liver Diseases(AASLD) surgical criteria by means of Harrell's C *** A total of 917 patients were considered. Five variables independently correlated with post-LR survival: Model for end-stage Liver Disease score, hepatitis C virus infection, number of nodules, largest diameter and vascular invasion. Three risk classes were identified, and oS for the three risk classes was significantly different both in the training(P on set(P = 0.0002). overall, 69.4% of patients were in the low-risk class, whereas only 37.8% were eligible to surgery according to EASL/AASLD. Survival of patients in the low-risk class was not significantly different compared with surgical indication for EASL/AASLD guidelines(77.2 mo vs 82.5 mo respectively, P = 0.22). Comparison of Harrell's C statistics revealed no significant difference in predictive power between the two systems(-0.00999, P = 0.667).CoNCLUSIoN This study established a new prognostic scoring system that may stratify HCC patients suitable for surgery, expanding surgical eligibility with respect to EASL/AASLD criteria with no harm on survival.

关键词： Hepatocellular carcinoma Liver resection Liver cirrhosis Prognosis Survival study

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Transarterial chemoembolization using 40 μm drug eluting beads for hepatocellular carcinoma

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World Journal of Radiology 2017年第5期9卷 245-252页

作者： Giorgio Greco Tommaso Cascella Antonio Facciorusso Roberto Nani Rodolfo Lanocita Carlo Morosi Marta Vaiani Giuseppina Calareso Francesca G Greco Antonio Ragnanese Marco A Bongini Alfonso V Marchianò vin.en.o mazzaferro Carlo Spreafico Department of Radiology Interventional RadiologyNuclear Medicine and RadiotherapyNational Cancer Institute Gastroenterology Unit Ospedali Riuniti FoggiaUniversity of Foggia Radiology and Interv-entional Radiology Unit Hepato-biliary Surgery and Liver Transplantation Unit National Cancer Institute

AIM To assess the safety and efficacy of transarterial chemoembolization(TACE) of hepatocellular carcinoma(HCC) using a new generation of 40 μm drug eluting beads in patients not eligible for curative *** Drug eluting bead TACE(DEB-TACE) using a new generation of microspheres(embozene tandem,40 μm) preloaded with 100 mg of doxorubicin was performed on 48 early or intermediate HCC patients with *** to therapy was assessed with Response Evaluation Criteria in Solid Tumors(RECIST) and modified RECIST(m RECIST) guidelines applied to computed tomography or magnetic resonance *** out of the 48 treated patients treated progressed on to receive liver orthotopic transplantation(oLT).This allowed for histological analysis on the treated explanted *** DEB-TACE with 40 μm showed a good safety profile without major complications or 30-d *** objective response rate of treated tumors was 72.6% and 26.7% according to m RECIST and RECIST *** examination in 11 patients assigned to oLT showed a necrosis degree > 90% in 78.6% of *** overall time to progression was 13 mo(11-21).CoNCLUSIoN DEB-TACE with 40 μm particles is an effective treatment for the treatment of HCC in early-intermediate patients(Barcelona Clinic Liver Cancer stage A/B) with a good safety profile and good results in term of objective response rate and necrosis.

关键词： Embozene tandem Drug eluting beads Drug eluting bead transarterial chemoembolization Transarterial chemoembolization Hepatocellular carcinoma

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