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World Journal of Clinical Cases 2024年第28期12卷 6241-6243页

作者： antonio giorgio Massimo De Luca Athena Clinic Center Via MatesePiedimonte Matese(CE)81016CampaniaItaly Liver Unit AORN CardarelliVia A.CardarelliNapoli 80131CampaniaItaly

This manuscript is based on a case reported by Song et al published in the World Journal of Clinical *** challenges remain in the field of hepatocellular carcinoma(HCC)conversion ***,only a limited number of patients with HCC accompanied by portal vein tumor thrombosis(PVTT)and hepatic vein tumor thrombosis(HVTT)are eligible for *** clinical case demonstrates that considering the complexity of the disease,a multimodal and multidisciplinary approach is essential for managing HCC accompanied by PVTT and ***,the outcomes of such surgeries remain *** conclusion,research on HCC conversion therapy is extremely useful for impro-ving treatment strategies for intermediate and advanced HCC,which currently have disappointing clinical outcomes.

关键词： Hepatocellular carcinoma Portal vein Inferior vena cava Tumor thrombus Conversion surgery

Quantitative assessment of self-management in patients with nonalcoholic fatty liver disease: An unmet clinical need

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World Journal of Gastroenterology 2024年第25期30卷 3143-3146页

作者： Raffaele Borriello giorgio Esposto Irene Mignini antonio Gasbarrini Maria Assunta Zocco CEMAD Digestive Disease Center Fondazione Policlinico Universitario A.Gemelli IRCCSCatholic University of RomeRome 00168Italy

In this editorial we comment on the article titled“Establishment and validation of an adherence prediction system for lifestyle interventions in non-alcoholic fatty liver disease”by Zeng et al published in a recent issue of the World Journal of ***-alcoholic fatty liver disease(NAFLD)represents one of the current challenges in hepatology and public health,due to its continuous growing prevalence and the rising incidence of NAFLD-related fibrosis,non-alcoholic steatohepatitis and *** only effective therapeutic strategy for this dis-ease is represented by encouraging patients to improve their lifestyle through the modification of dietary intake and increased physical exercise,but the effective application of such modifications is often limited by various factors such as lack of information,psychological barriers or poor social *** poor adherence to a healthy lifestyle can be decisive in determining the clinical outcome,in daily practice there is a lack of quantitative instruments aimed at identifying patients with the lowest adherence to lifestyle changes and higher risk of disease progre-ssion in the course of *** this article,Zeng et al propose a quantitative scale to assess the grade of adherence of patients with NAFLD to hea-lthy lifestyle intervention,called the Exercise and Diet Adherence Scale(EDAS).This scale,consisting of 33 items divided into 6 dimensions which relates to six subjective aspects in the self-management of NAFLD,has shown a good correlation with the identification of the sub-cohort of patients with the highest reduction in caloric intake,increase in physical exercise,probability of a reduction in liver stiffness measurement and alanine aminotransferase *** cor-relation among clinical outcomes and specific dimensions of this scale also highlights the pivotal role of a good and confidential doctor-patient relationship and of an effective *** is an urgent need for practical and e

关键词： Non-alcoholic fatty liver disease Non-alcoholic steatohepatitis Liver cirrhosis Metabolic associated fatty liver disease Metabolic associated steatohepatitis Insulin resistance Self-management Self-management measurement Patient education

Ablative therapies for intrahepatic cholangiocarcinoma

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Hepatobiliary Surgery and Nutrition 2018年第3期7卷 192-194页

作者： antonio giorgio Pietro Gatti Paolo Matteucci Valentina giorgio Interventional Ultrasound Unit Tortorella Clinical HospitalSalernoItaly Internal Medicine Division Ostuni HospitalOstuni BRItaly Radiation Oncology Institute Campus Biomedico UniversityRomeItaly Pediatric Gastroenterology Unit Sacred Heart UniversityPoliclinico GemelliRomeItaly

Among the 3 sub-types of cholangiocarcinoma (CH), [intrahepatic CH, hylar (CH) and extrahepatic (CH)], intrahepatic cholangiocarcinoma (ICC) accounts for up 8–10% of cholangiocarcinomas and 10–20% of all primary liv... 详细信息

关键词： carcinoma liver for

Shear-wave elastography to predict hepatocellular carcinoma after hepatitis C virus eradication:A systematic review and meta-analysis

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World Journal of Gastroenterology 2024年第10期30卷 1450-1460页

作者： giorgio Esposto Paolo Santini Linda Galasso Irene Mignini Maria Elena Ainora antonio Gasbarrini Maria Assunta Zocco CEMAD Digestive Disease Center Fondazione Policlinico Universitario“A.Gemelli”IRCCSCatholic University of RomeRome 00168Italy Fondazione Policlinico Universitario Agostino Gemelli IRCCS Fondazione Policlinico Universitario Agostino Gemelli IRCCS-UniversitàCattolica del Sacro CuoreRome 00168Italy Medicina Interna e Gastroenterologia CEMAD Digestive Disease CenterUniversitàCattolica del Sacro CuoreFondazione Policlinico Universitario A Gemelli IRCCSRome 00168Italy

BACKGROUND Direct-acting antiviral agents(DAAs)are highly effective treatment for chronic hepatitis C(CHC)with a significant rate of sustained virologic response(SVR).The achievement of SVR is crucial to prevent additional liver damage and slow down fibrosis *** assessment of fibrosis degree can be performed with transient elastography,magnetic resonance elastography or shear-wave elastography(SWE).Liver elastography could function as a predictor for hepato-cellular carcinoma(HCC)in CHC patients treated with *** To explore the predictive value of SWE for HCC development after complete clearance of hepatitis C virus(HCV).METHODS A comprehensive literature search of clinical studies was performed to identify the ability of SWE to predict HCC occurrence after HCV *** accordance with the study protocol,a qualitative and quantitative analysis of the evidence was *** At baseline and after 12 wk of follow-up,a trend was shown towards greater liver stiffness(LS)in those who go on to develop HCC compared to those who do not[baseline LS standardized mean difference(SMD):1.15,95%confidence interval(95%CI):020-2.50;LS SMD after 12 wk:0.83,95%CI:0.33-1.98].The absence of a statistically significant difference between the mean LS in those who developed HCC or not may be related to the inability to correct for confounding factors and the absence of raw source *** was a statist-ically significant LS SMD at 24 wk of follow-up between patients who developed HCC vs not(0.64;95%CI:0.04-1.24).CONCLUSION SWE could be a promising tool for prediction of HCC occurrence in patients treated with *** studies with larger cohorts and standardized timing of elastographic evaluation are needed to confirm these data.

关键词： Shear-wave elastography Hepatocellular carcinoma Hepatitis C virus Sustained virologic response

Contrast-enhanced ultrasound with sulphur-hexafluoride in diagnosis of early HCC in cirrhosis

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Hepatoma Research 2019年第6期5卷 16-24页

作者： antonio giorgio Pietro Gatti Paolo Matteucci Valentina giorgio Department of Medicine Interventional Ultrasound UnitAthena Clinical InstituteCaserta 81016Italy Department of Medicine Brindisi General HospitalBrindisi 72100Italy Radiation Oncology Institute Campus Biomedico UniversityRome 00128Italy Fondazione Policlinico A.Gemelli IRCCS Department of Woman and Child Health and Public HealthRoma 00168Italy

Contrast-enhanced ultrasound(CEUS)with pure blood stream contrast agents allow the study of blood supply of focal liver lesions and especially of hepatocellular carcinoma(HCC)in *** sensitivity and specificity in diagnosis of small tumors is very *** review summarizes the recent results on CEUS with SonoVue,which is one of the second generation contrast agents,in the diagnosis of early HCC in cirrhosis emphasizing its increasing role in routine clinical practice.

关键词： Hepatocellular carcinoma contrast-enhanced ultrasound cirrhosis early hepatocellular carcinoma

Editorial on "Role of thermal ablation in the management of colorectal liver metastasis"

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Hepatobiliary Surgery and Nutrition 2020年第1期9卷 62-64页

作者： antonio giorgio Pietro Gatti Massimo De Luca Paolo Matteucci Valentina giorgio Liver Unit and Interventional Ultrasound Unit Athena Clinical InstitutePiedimonte Matese(CE)Italy Internal Medicine Unit Brindisi General HospitalBrindisiItaly Liver Unit Cardarelli HospitalNaplesItaly Radiation Oncology Unit Campus BiomedicoRomaItaly Fondazione Policlinico A.Gemelli IRCCS Department of Woman and Child Health and Public HealthRomaItaly

The last 30 years have shown the increasing role of Ablation in the treatment of malignant liver tumors. By the introduction of percutaneous ethanol injection (PEI) as first ablation tool for percutaneous treatment of hepatocellular carcinoma (HCC) in cirrhosis that firstly showed very high efficacy (1), several ablation techniques (mainly thermal) have been introduced in clinical practice aimed at destroying primary and secondary hepatic tumors as alternative or substitute tools to surgery. Radiofrequency ablation (RFA) was the first thermal technique that showed a good efficacy to ablate liver metastases (2). Among the secondary liver tumors, colorectal liver metastases (CRLM) represent the unique indication for ablation (2). Unlike HCC in cirrhosis where the role of RFA is well defined as first line therapy for HCC nodules < or equal to 2 cm or as alternative to surgery in 1-3 HCC nodules with the maximum diameter<3 cm (3), in the case of CRLM it is not possible to reproduce the same paradigm. Liver resection remains the standard of care for CRLM and the indications to ablation remain confined to nonresectable patients (4). The review article by Takahashi and Berber recently published in HBSN wells illustrates the current role of ablation in treatment of CRLM (5).

关键词： colorectal metastasis surgery

Dynamic contrast enhanced ultrasound in differential diagnosis of hepatocellular carcinoma: A systematic review and meta-analysis

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World Journal of Gastrointestinal Oncology 2024年第6期16卷 2804-2815页

作者： giorgio Esposto Paolo Santini Fabrizio Termite Linda Galasso Irene Mignini Maria Elena Ainora antonio Gasbarrini Maria Assunta Zocco Department of CEMAD Digestive Disease Center Fondazione Policlinico Universitario A Gemelli IRCCSCatholic University of RomeRome 00168Italy Department of Fondazione Policlinico Universitario Agostino Gemelli IRCCS UniversitàCattolica del Sacro CuoreRome 00168Italy Department of Medicina Interna e Gastroenterologia CEMAD Digestive Disease CenterFondazione Policlinico Universitario A Gemelli IRCCSUniversitàCattolica del Sacro CuoreRome 00168Italy

BACKGROUND Non-invasive differential diagnosis between hepatocellular carcinoma(HCC)and other liver cancer(*** or metastasis)is highly challenging and definitive diagnosis still relies on histological *** patterns of enhancement and wash-out of liver nodules can be used to stratify the risk of malignancy only in cirrhotic patients and HCC frequently shows atypical *** contrast-enhanced ultrasound(DCEUS)with standardized software could help to overcome these obstacles,providing functional and quantitative parameters and potentially improving accuracy in the evaluation of tumor *** To explore clinical evidence regarding the application of DCEUS in the differential diagnosis of liver *** A comprehensive literature search of clinical studies was performed to identify the parameters of DCEUS that could relate to histological *** accordance with the study protocol,a qualitative and quantitative analysis of the evidence was *** Rise time was significantly higher in HCC patients with a standardized mean difference(SMD)of 0.83(95%CI:0.48-1.18).Similarly,other statistically significant parameters were mean transit time local with a SMD of 0.73(95%CI:0.20-1.27),peak enhancement with a SMD of 0.37(95%CI:0.03-0.70),area wash-in area under the curve with a SMD of 0.47(95%CI:0.13-0.81),wash-out area under the curve with a SMD of 0.55(95%CI:0.21-0.89)and wash-in and wash-out area under the curve with SMD of 0.51(95%CI:0.17-0.85).SMD resulted not significant in fall time and wash-in rate,but the latter presented a trend towards greater values in HCC compared to intrahepatic *** DCEUS could improve non-invasive diagnosis of HCC,leading to less liver biopsy and early *** quantitative analysis needs to be applied on larger cohorts to confirm these preliminary results.

关键词： Dynamic contrast enhanced ultrasound Hepatocellular carcinoma Intracellular cholangiocarcinoma Quantitative ultrasound Liver cancer Time-intensity curve

Intrahepatic Cholangiocarcinoma and Thermal Ablation:Long-term Results of An Italian Retrospective Multicenter Study

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Journal of Clinical and Translational Hepatology 2019年第4期7卷 287-292页

作者： antonio giorgio Pietro Gatti Luca Montesarchio Bruno Santoro Andrea Dell’Olio Nicola Crucinio Carmine Coppola Ferdinando Scarano Fabio De Biase Emanuela Cirac Stefano Semeraro Valentina giorgio Liver Unit and Interventional Ultrasound Unit Athena Clinical InstitutePiedimonte Matese(CE)Italy Internal Medicine Unit Brindisi General HospitalBrindisiItaly General Surgery Unit Polla General HospitalPolla(SA)Italy Department of Radiology Bisceglie Hospital-ASL BATBisceglieItaly Gastroenterology Unit Foggia General HospitalFoggiaItaly Department of Internal Medicine Hepatology Interventional UnitGragnano HospitalGragnano(NA)Italy Internal Medicine Unit Ostuni HospitalOstuni(BR)Italy Fondazione Policlinico A.Gemelli IRCCS Department of Woman and Child Health and Public HealthLargo A GemelliRomaItaly

Background and Aims: Despite resection being considered the treatment of choice for intrahepatic cholangiocarcinoma(ICC),percutaneous thermal ablation can be an alter-native treatment for patients unfit for *** aim was to compare long-term results of percutaneous sonographi-cally-guided radiofrequency ablation(RFA)with high-powered microwave ablation(MWSA)in treatment of ***: Results of 71 ICC patients with 98 nodules treated with RFA(36 patients)or MWSA(35 patients)between January 2008 and June 2018 in 5 Interventional Ultrasound centers of Southern Italy were retrospectively ***-mulative overall survival curves were calculated with the Ka-plan-Meyer method and differences with the log-rank *** possible factors affecting survival were ***: Overall survival of the entire series was 88%,65%,45%and 34%at 12,36,60 and 80 months,*** treated with MWSA survived longer than pa-tients treated with RFA(p 4 cm,no significant difference was ***-free sur-vival and progression-free survival were better in the MWSA group compared to the RFA group(p < 0.005).Diameter of nodules and MWSA were independent factors predicting a better *** major complications were ***: MWSA is superior to RFA in treating ICC unfit for surgery,achieving better long-term survival in small(≤3 cm)ICC nodules as well as nodules up to 4 cm of neo-plastic tumors and should replace RFA.

关键词： Intrahepatic cholangiocarcinoma Thermal ablation Microwaves Radiofrequency Percutaneous treatment

Intranasal nerve growth factor for prevention and recovery of the outcomes of traumatic brain injury

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Neural Regeneration Research 2023年第4期18卷 773-778页

作者： Luigi Manni giorgio Conti antonio Chiaretti Marzia Soligo Institute of Translational Pharmacology National Research Council of Italy(CNR)RomeItaly Intensive Pediatric Therapy and Pediatric Trauma Center Department of EmergencyAnesthesiological and Reanimation SciencesFondazione Policlinico Universitario A.Gemelli IRCCSRomeItaly Institute of Pediatrics Department of Woman and Child HealthFondazione Policlinico Universitario A.Gemelli IRCCSRomeItaly

Traumatic brain injury is one of the main causes of mortality and disability *** brain injury is characterized by a primary injury directly induced by the impact,which progresses into a secondary injury that leads to cellular and metabolic damages,starting in the first few hours and days after primary mechanical *** date,traumatic brain injury is not targetable by therapies aimed at preventing and/or limiting the outcomes of secondary damage but only by palliative *** growth factor is a neurotrophin targeting neuronal and non-neuronal cells,potentially useful in preventing/limiting the outcomes of secondary damage in traumatic brain *** potential has further increased in the last two decades since the possibility of reaching neurotrophin targets in the brain through its intranasal delivery has been ***,molecules intranasally delivered to the brain parenchyma may easily bypass the blood-brain barrier and reach their therapeutic targets in the brain,with favorable kinetics,dynamics,and safety *** the first part of this review,we aimed to report the traumatic brain injury-induced dysfunctional mechanisms that may benefit from nerve growth factor *** the second part,we then exposed the experimental evidence relating to the action of nerve growth factor(both in vitro and in vivo,after administration routes other than intranasal)on some of these *** the last part of the work,we,therefore,discussed the few manuscripts that analyze the effects of treatment with nerve growth factor,intranasally delivered to the brain parenchyma,on the outcomes of traumatic brain injury.

关键词： intranasal delivery nerve growth factor pharmacology traumatic brain injury

Stone-scoring systems for predicting complications in percutaneous nephrolithotomy:A systematic review of the literature

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Asian Journal of Urology 2023年第3期10卷 226-238页

作者： giorgio Mazzon Simon Choong antonio Celia Department of Urology AULSS7 PedemontanaSan Bassiano HospitalBassano Del GrappaItaly Institute of Urology University College Hospitals of LondonLondonUK

Objective:Percutaneous nephrolithotomy is a treatment of choice for larger stones of the upper urinary ***,several nephrolithometric nomograms for prediction of post-operative surgical outcomes have been proposed,although uncertainties still exist regarding their roles in the estimation of ***:We conducted a systematic review on PubMed and Web of Sciences databases including English studies with at least 100 cases and published between January 2010 and December *** identified original articles evaluating correlations between the Guy’s stone score,the stone size(S),tract length(T),obstruction(O),number of involved calices(N),and essence or stone density(E)(S.T.O.N.E.),Clinical Research Office of the Endourological Society(CROES),and Seoul National University Renal Stone Complexity(S-ReSC)scores and post-operative complications in adult *** also included newly designed nomograms for prediction of specific ***:After an initial search of 549 abstracts,we finally included a total of 18 *** them,11 investigated traditional nephrolithometric nomograms,while seven newly designed nomograms were used to predict specific ***,7316 patients have been *** total,14 out of 18 papers are derived from retrospective single-center ***’s stone score obtained correlation with complications in five,*** score in four,while CROES score and S-ReSC score in three and two,*** of the studies investigated minimally invasive percutaneous nephrolithotomy(PCNL)and all cases have been conducted in prone *** newly designed nomograms,none of them is currently externally validated;five of them predict post-operative infections;the remaining two have been designed for thromboembolic events and urinary ***:This review presents all nomograms currently available in the PCNL field and highlights a certain number of *** data ha

关键词： Percutaneous nephrolithotomy Complications Nomogram Stone-scoring system Clavien-Dindo