检索结果-南通市图书馆

Role of spleen elastography in patients with chronic liver diseases

World Journal of Gastroenterology 2016年第35期22卷 7857-7867页

作者： Mariangela Giunta dario conte Mirella Fraquelli Gastro-enterology and Endoscopy Unit Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico 20122 Milan Italy Department of Pathophysiology and Organ Transplantation Università degli Studi di Milano

The development of liver cirrhosis and portal hypertension(PH), one of its major complications, are structural and functional alterations of the liver, occurring in many patients with chronic liver diseases(CLD). Actually the progressive deposition of hepatic fibrosis has a key role in the prognosis of CLD patients. The subsequent development of PH leads to its major complications, such as ascites, hepatic encephalopathy, variceal bleeding and decompensation. Liver biopsy is still considered the reference standard for the assessment of hepatic fibrosis, whereas the measurement of hepatic vein pressure gradient is the standard to ascertain the presence of PH and upper endoscopy is the method of choice to detect the presence of oesophageal varices. However, several non-invasive tests, including elastographic techniques, are currently used to evaluate the severity of liver disease and predict its prognosis. More recently, the measurement of the spleen stiffness has become particularly attractive to assess, considering the relevant role accomplished by the spleen in splanchnic circulation in the course of liver cirrhosis and in the PH. Moreover, spleen stiffness as compared with liver stiffness better represents the dynamic changes occurring in the advanced stages of cirrhosis and shows higher diagnostic performance in detecting esophageal varices. The aim of this review is to provide an exhaustive overview of the actual role of spleen stiffness measurement as assessed by several elastographic techniques in evaluating both liver disease severity and the development of cirrhosis complications, such as PH and to highlight its potential and possible limitations.

关键词： Cirrhosis spleen stiffness elastography Portal hypertension Transient elastography

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Micronutrient deficiencies in patients with chronic atrophic autoimmune gastritis: A review

引用

World Journal of Gastroenterology 2017年第4期23卷 563-572页

作者： Federica Cavalcoli Alessandra Zilli dario conte Sara Massironi Gastroenterology and Endoscopy Unit Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico Postgraduate School of Gastroenterology Department of Pathophysiology and TransplantationUniversitàdegli Studi di Milano

Chronic atrophic autoimmune gastritis (CAAG) is an organ-specific autoimmune disease characterized by an immune response, which is directed towards the parietal cells and intrinsic factor of the gastric body and fundus and leads to hypochlorhydria, hypergastrinemia and inadequate production of the intrinsic factor. As a result, the stomach’s secretion of essential substances, such as hydrochloric acid and intrinsic factor, is reduced, leading to digestive impairments. The most common is vitamin B12 deficiency, which results in a megaloblastic anemia and iron malabsorption, leading to iron deficiency anemia. However, in the last years the deficiency of several other vitamins and micronutrients, such as vitamin C, vitamin D, folic acid and calcium, has been increasingly described in patients with CAAG. In addition the occurrence of multiple vitamin deficiencies may lead to severe hematological, neurological and skeletal manifestations in CAAG patients and highlights the importance of an integrated evaluation of these patients. Nevertheless, the nutritional deficiencies in CAAG are largely understudied. We have investigated the frequency and associated features of nutritional deficiencies in CAAG in order to focus on any deficit that may be clinically significant, but relatively easy to correct. This descriptive review updates and summarizes the literature on different nutrient deficiencies in CAAG in order to optimize the treatment and the follow-up of patients affected with CAAG.

关键词： Chronic atrophic autoimmune gastritis Nutritional deficiency Vitamin B12 Iron Vitamin C Vitamin D Calcium Malabsorption

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Severe chronic diarrhea and maculopapular rash:A case report

引用

World Journal of Gastroenterology 2011年第34期17卷 3948-3952页

作者： Alessandra Elvevi Federica Grifoni Federica Branchi Umberto Gianelli dario conte Gastrointestinal Unit 2 Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico and University of Milan Federica Grifoni Hematology Unit Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico and University of Milan Umberto Gianelli Department of Pathology Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico and University of Milan

Systemic mastocytosis (SM) is a heterogeneous disease of the bone marrow characterized by abnormal growth, accumulation and activation of clonal mast cells (MCs). We report a case of SM with multiorgan involvement. A 30-year-old man presented with diarrhea, flushing, maculopapular rash with itching and weight loss. The upper and lower gastrointestinal endoscopies showed macroscopic involvement of stomach and duodenum; mucosal samples from stomach, duodenum, colon and distal ileum showed mucosal inf iltration by large, spindleshaped MCs with abnormal surface molecule expression (CD2 and CD25), a picture fully consistent with SM, according to the World Health Organization diagnostic criteria. A computed tomography scan showed diffuse lymphadenopathy, hepatosplenomegaly and diffuse small bowel involvement. Bone marrow aspirate and biopsy were diagnostic for SM; serum tryptase levels were increased (209 ng/mL, normal values < 20 ng/mL). The conclusive diagnosis was smouldering SM. There wereno therapeutic indications except for treatment of symptoms. The patient was strictly followed up because of the risk of aggressive evolution.

关键词： Mast cells Systemic mastocytosis Bone marrow Tryptase

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Non-invasive evaluation of intestinal disorders: The role of elastographic techniques

引用

World Journal of Gastroenterology 2017年第16期23卷 2832-2840页

作者： Federica Branchi Flavio Caprioli Stefania Orlando dario conte Mirella Fraquelli Gastroenterology and Endoscopy Unit Fondazione IRCCS Ca’Granda Ospedale Maggiore Policlinico20122 MilanItaly Department of Pathophysiology and Transplantation Universitàdegli Studi di Milano20122 MilanItaly

Over the recent years the non-invasive techniques for the evaluation of the small bowel have been playing a major role in the management of chronic intestinal diseases, such as inflammatory bowel diseases(IBD). The diagnostic performances of magnetic resonance imaging, computed tomography and ultrasound in the field of small bowel disorders, have been assessed and established for more than two decades. Newer sonographic techniques, such as strain elastography and shear wave elastography, have been put forward for the assessment of disease activity and characterization of IBD-related damage in the setting of Crohn's disease and other gastrointestinal disorders. The data from the preliminary research and clinical studies have shown promising results as regards the ability of elastographic techniques to differentiate inflammatory from fibrotic tissue. The distinction between IBD activity(inflammation) and IBD-related damage(fibrosis) is currently considered crucial for the assessment and management of patients. Moreover, all the elastographic techniques are currently being considered in the setting of other intestinal disorders(e.g., rectal tumors, appendicitis). The aim of this paper is to offer both a comprehensive narrative review of the non-invasive techniques available for the assessment of small-bowel disorders, with particular emphasis on inflammatory bowel diseases, and a summary of the current evidence on the use of elastographic techniques in this setting.

关键词： elastography Fibrosis Inflammatory bowel disease Bowel wall Stricture

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Ultrasound elastographic techniques in focal liver lesions

引用

World Journal of Gastroenterology 2016年第9期22卷 2647-2656页

作者： Clara Benedetta Conti Federica Cavalcoli Mirella Fraquelli dario conte Sara Massironi Gastroenterology and Endoscopy Unit Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico Department of Pathophysiology and Organ Transplantation Università degli Studi di Milano

Elastographic techniques are new ultrasound-based imaging techniques developed to estimate tissue deformability/stiffness. Several ultrasound elastographic approaches have been developed, such as static elastography, transient elastography and acoustic radiation force imaging methods, which include point shear wave and shear wave imaging elastography. The application of these methods in clinical practice aims at estimating the mechanical tissues properties. One of the main settings for the application of these tools has been liver stiffness assessment in chronic liver disease, which has been studied mainly using transient elastography. Another field of application for these techniques is the assessment of focal lesions, detected by ultrasound in organs such as pancreas, prostate, breast, thyroid, lymph nodes. Considering the frequency and importance of the detection of focal liver lesions through routine ultrasound, some studies have also aimed to assess the role that elestography can play in studying the stiffness of different types of liver lesions, in order to predict their nature and thus offer valuable non-invasive methods for the diagnosis of liver masses.

关键词： Focal liver lesions Acoustic radiation force imaging Transient elastography Elastographic techniques Shear wave imaging

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Is there still a role for the hepatic locoregional treatment of metastatic neuroendocrine tumors in the era of systemic targeted therapies?

引用

World Journal of Gastroenterology 2017年第15期23卷 2640-2650页

作者： Federica Cavalcoli Emanuele Rausa dario conte Antonio Federico Nicolini Sara Massironi Gastro-enterology and Endoscopy Unit Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico Postgraduate School of Gastroenterology Department of Pathophysiology and TransplantationUniversitàdegli Studi di Milano Department of Colorectal Diseases St.Vincent's University Hospital Department of Interventional Radiology Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico

Gastroenteropancreatic neuroendocrine neoplasms(GEP-NENs) frequently present with distant metastases at the time of diagnosis and the liver is the most frequent site of spreading. The early identification of metastatic disease represents a major prognostic factor for GEP-NENs patients. Radical surgical resection, which is feasible for a minority of patients, is considered the only curative option, while the best management for patients with unresectable liver metastases is still being debated. In the last few years, a number of locoregional and systemic treatments has become available for GEP-NEN patients metastatic to the liver. However, to date only a few prospective studies have compared those therapies and the optimal management option is based on clinical judgement. Additionally, locoregional treatments appear feasible and safe for disease control for patients with limited liver involvement and effective in symptoms control for patients with diffuse liver metastases. Considering the lack of randomized controlled trials comparing the locoregional treatments of liver metastatic NEN patients, clinical judgment remains key to set the most appropriate therapeutic pathway. Prospective data may ultimately lead to more personalized and optimized treatments. The present review analyzes all the locoregional therapy modalities(i.e., surgery, ablative treatments and transarterial approach) and aims to provide clinicians with a useful algorithm to best treat GEP-NEN patients metastatic to the liver.

关键词： Gastroenteropancreatic neuroendocrine neoplasms Liver metastases Locoregional therapies Systemic therapies Ablation Chemoembolization

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Non-invasive assessment of liver fibrosis in chronic hepatitis B

引用

World Journal of Gastroenterology 2014年第40期20卷 14568-14580页

作者： Federica Branchi Clara Benedetta Conti Alessandra Baccarin Pietro Lampertico dario conte Mirella Fraquelli Second Division of Gastroenterology IRCCS Fondazione Cà Granda Ospedale Maggiore Policlinico Università degli Studi di Milano 20122 Milan Italy First Division of Gastroenterology IRCCS Fondazione Cà Granda Ospedale Maggiore Policlinico Università degli Studi di Milano 20122 Milan Italy

The goal of this review is to provide a comprehensive picture of the role,clinical applications and future perspectives of the most widely used non-invasive techniques for the evaluation of hepatitis B virus(HBV)*** the past decade many non-invasive methods have been developed to reduce the need for liver biopsy in staging fibrosis and to overcome whenever possible its limitations,mainly:invasiveness,costs,low reproducibility,poor acceptance by *** techniques conceived to assess liver stiffness,in particular transient elastography,and the most commonly used biological markers will be assessed against their respective role and limitations in staging hepatic *** evidence highlights that both liver stiffness and some bio-chemical markers correlatewith survival and major clinical end-points such as liver decompensation,development of hepatocellular carcinoma and portal *** the non-invasive techniques here discussed can play a major role in the management of patients with chronic HBV-related *** their prognostic value,transient elastography and some bio-chemical markers can be used to better categorize patients with advanced fibrosis and cirrhosis and assign them to different classes of risk for clinically relevant *** recent data indicates that the combined measurements of liver and spleen stiffness enable the reliable prediction of portal hypertension and esophageal varices development.

关键词： Liver fibrosis Cirrhosis Hepatitis B virus Transient elastography Non invasive markers

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Somatostatin analogs for gastric carcinoids:for many, but not all

引用

World Journal of Gastroenterology 2015年第22期21卷 6785-6793页

作者： Sara Massironi Alessandra Zilli dario conte Gastroenterology and Endoscopy Unit Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico Department of Pathophysiology and Transplantation Università degli Studi di Milano

Gastric carcinoids(GCs) are classified as: type Ⅰ,related to hypergastrinemia due to chronic atrophic gastritis(CAG), type Ⅱ, associated with Zollinger-Ellison syndrome in multiple endocrine neoplasia type 1, and type Ⅲ, which is normogastrinemic. The management of type-Ⅰ gastric carcinoids(GC1s) is still debated,because of their relatively benign course. According to the European Neuroendocrine Tumor Society guidelines endoscopic resection is indicated whenever possible;however, it is not often feasible because of the presence of a multifocal disease, large lesions, submucosal invasion or, rarely, lymph node involvement. Therefore,somatostatin analogs(SSAs) have been proposed as treatment for GC1 s in view of their antisecretive,antiproliferative and antiangiogenic effects. However,in view of the high cost of this therapy, its possible side effects and the relatively benign course of the disease,SSAs should be reserved to specific subsets of "high risk patients", i.e., those patients with multifocal or recurrent GCs. Indeed, it is reasonable that, after the development of a gastric neuroendocrine neoplasm in patients with a chronic predisposing condition(such as CAG), other enterochromaffin-like cells can undergo neoplastic proliferation, being chronically stimulated by hypergastrinemia. Therefore, definite indications to SSAs treatment should be established in order to avoid the undertreatment or overtreatment of GCs.

关键词： Neuroendocrine tumors Atrophic gastritis Octreotide Lanreotide Enterochromaffin-like cells Carcinoid tumors

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

“Pseudotumoral” hepatic pattern in acute alcoholic hepatitis:A case report

引用

World Journal of Gastroenterology 2009年第32期15卷 4070-4074页

作者： Andrea Tenca Sara Massironi Agostino Colli Guido Basilisco dario conte Policlinico MangiagalliRegina Elena FoundationGastrointestinal Unit 2 and Postgraduate School of Gastro-enterologyUniversità degli Studi di MilanoF.Sforza st.3520122 MilanItaly Department of Internal Medicine Ospedale "A.Manzoni"Lecco 23900Italy

In acute alcoholic hepatitis (AAH), a "pseudotumoral" appearance of the liver parenchyma on computed tomography (CT) scan has been reported. The main findings are hypervascularized areas closely similar to those observed in large hepatocellular carcinomas. We report a case of a patient affected by AAH with an unusual appearance of these "pseudotumoral" areas on CT scan, close resembling a metastatic cancer rather than a primary hepatocellular carcinoma. In fact, in contrast with previous reports, the picture was characterized by the presence of many inhomogeneous, hypoattenuated areas highlighted during both pre- and post-contrast phases. Moreover, we report the first description of "pseudotumoral" lesions on ultrasound scan. This patient was successfully treated with corticosteroids, even if many controversies still exist regarding their efficacy in this setting.

关键词： Acute alcoholic hepatitis Pseudotumoralhepatic lesions Alcoholic liver disease Computed tomography Ultrasound

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Anti-tumour necrosis factor agent and liver injury:literature review,recommendations for management

引用

World Journal of Gastroenterology 2014年第46期20卷 17352-17359页

作者： Roberta Elisa Rossi Ioanna Parisi Edward John Despott Andrew Kenneth Burroughs James O'Beirne dario conte Mark Ian Hamilton Charles Daniel Murray Centre for Gastroenterology Royal Free HospitalLondon NW3 2QGUnited Kingdom Department of Pathophysiology and Organ Transplant Universita’ degli Studi di Milano20122 MilanoItaly Division of Gastroenterology and Endoscopy Fondazione IRCCS Ca' GrandaOspedale Maggiore Policlinico20122 MilanoItaly Sheila Sherlock Liver Centre Royal Free Hospital and Institute of Liver and Digestive HealthLondon NW3 2PFUnited Kingdom

Abnormalities in liver function tests,including transient and self-limiting hypertransaminasemia,cholestatic disease and hepatitis,can develop during treatment with anti-tumour-necrosis-factor(TNF)*** optimal management of liver injury related to antiTNF therapy is still a matter of *** some authors recommend discontinuing treatment in case of both a rise of alanine aminotransferase more than5 times the upper limit of normal,or the occurrence of jaundice,there are no standard guidelines for the management of anti-TNF-related liver *** searches were performed in Pub Med,using the following key words:inflammatory bowel disease(IBD);TNF inhibitors;hypertransaminasemia;drugrelated liver injury;*** to published data,elevation of transaminases in patients with IBD treated with anti-TNF is a common finding,but resolution appears to be the usual ***-TNF agents seem to be safe with a low risk of causing severe drugrelated liver *** to our centre experience,we found that hypertransaminasemia was a common,mainly self-limiting finding in our IBD cohort and was not correlated to infliximab treatment on both univariate and multivariate *** algorithm for the management of liver impairment occurring during antiTNF treatment is also proposed and this highlights the need of a multidisciplinary approach and suggests liver biopsy as a key-point in the management decision in case of severe rise of ***,hepatic injury is generally self-limiting and drug withdrawal seems to be an exception.

关键词： Inflammatory bowel disease Tumour necrosis factor inhibitors Hypertransaminasemia Drug-related liver injury Infliximab

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

欢迎您,

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案：

请选择收藏分类：

通借通还

欢迎您,

建议与咨询 留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案： 新增检索档案 确定 取消

请选择收藏分类： 新增自定义分类 确定 取消

通借通还

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

请选择保存的检索档案：

请选择收藏分类：