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World Journal of Hepatology 2017年第6期9卷 333-342页

作者： Sirio Fiorino Maria Letizia Bacchi-Reggiani Paolo Leandri elisabetta Loggi Pietro Andreone Unità Operativa di Medicina Interna C Ospedale Maggiore Unità Operativa Malattie Cardiovascolari Azienda Ospedaliero Universitaria di BolognaPoliclinico Sant’Orsola-Malpighi Dipartimento di Scienze Mediche e Chirurgiche Azienda Ospedaliero Universitaria di BolognaPoliclinico Sant’Orsola-Malpighi

AIM To assess vitamin E efficacy,defined as its ability to induce hepatitis B e antigen(HBeAg) seroconversion,in children with HBeAg-positive persistent *** In July 2016,we extracted articles published in MEDLINE and the Cochrane Library using the following search terms:"chronic hepatitis B","children","childhood","therapy","treatment","vitamin E","tocopherols","tocotrienols".Only randomized controlled trials(RCTs) published in English language were *** Three RCTs met inclusion criteria and were considered in the present ***,23/122 children in the treatment group underwent HBeAg seroconversion vs 3/74 in the control group(OR=3.96,95%CI:1.18-13.25,P=0.025).CONCLUSION Although our meta-analysis has several limits,including the very small number of available studies and enrolled children with HBeAg positivity-related hepatitis,it suggests that vitamin E use may enhance the probability to induce HBeAg seroconversion in these *** well designed and adequately sized trials are required to confirm or deny these very preliminary results.

关键词：肝炎 B 小儿科的 hepatology 病毒的肝炎免疫学

Helical tomotherapy for duodenal adenocarcinoma in an elderly patient: A case report

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World Journal of Gastrointestinal Oncology 2017年第2期9卷 94-97页

作者： Valentina Lancellotta Giuseppe Russo Marco Lupattelli Martina Iacco elisabetta Perrucci Claudio Zucchetti Lorenzo Falcinelli Cynthia Aristei Radiation Oncology Section Department of Surgical and Biomedical Sciences University of Perugia Perugia General Hospital Gastroenterology Division Perugia General Hospital Radiation Oncology Division Perugia General Hospital Medical Physics Unit Perugia General Hospital

To evaluate the efficacy and feasibility of external beam radiotherapy(EBRT) for duodenal adenocarcinoma in an 84-year-old female who underwent EBRT(2.2 Gy/d for a total dose of 46.2 Gy) using helical tomotherapy(HT). Toxicity was evaluated on the National Cancer Institute's common toxicity criteria(CTCAE 3.0). The patient completed the treatment without G3-G4 toxicity. After 22-mo follow-up, she is alive and well, in complete remission with no late side effects. HT seems to be feasible and effective for duodenal adenocarcinoma in old to very old patients.

关键词：老十二指肠的癌螺旋状的 tomotherapy 毒性

Wireless capsule endoscopy and proximal small bowel lesions in Crohn’s disease

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World Journal of Gastroenterology 2010年第26期16卷 3299-3304页

作者： Carmelina Petruzziello Sara Onali Emma Calabrese Francesca Zorzi Marta Ascolani Giovanna Condino elisabetta Lolli Paola Naccarato Francesco Pallone Livia Biancone GI Unit Department of Internal Medicine University "Tor Vergata" Rome 00133 Italy

AIM: To investigate the prevalence of proximal small bowel (SB) lesions detected by wireless capsule endoscopy (WCE) in Crohn's disease (CD). METHODS: WCE was performed in 64 patients: 32 with CD of the distal ileum, and 32 controls with iron-deficiency anemia (IDA) or diarrhea. WCE was performed using the Given SB-WCE, followed by small intestine contrast ultrasonography (SICUS). Findings compatible with CD by using WCE included erosions, aphthoid or deep ulcers, and strictures/stenosis. RESULTS: WCE detected proximal SB lesions in 16/32 (50%) patients (14 aphthoid ulcers, 2 deep ulcers, one stricture), which appeared not to be related to clinical parameters [epigastric pain, age, smoking, non-steroidalanti-inflammatory drugs (NSAIDs), IDA]. Among patients with proximal SB lesions, 6 (37%) were smokers, 3 (19%) NSAID users, 3 (19%) had epigastric pain and 4 (25%) had IDA. SICUS detected proximal SB lesions in 3/32 patients (19%) also showing lesions with WCE. No correlations were observed between proximal SB lesions assessed by WCE or by SICUS (χ2 = 1.5, P = 0.2). CONCLUSION: The use of WCE allows the detection of previously unknown upper SB lesions in a high proportion of patients with a previous diagnosis of CD involving the distal ileum.

关键词： Wireless capsule endoscopy Crohn’s disease Small bowel

Is it time to give up with calcineurin inhibitors in kidney transplantation?

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World Journal of Transplantation 2013年第2期3卷 7-25页

作者： Maurizio Salvadori elisabetta Bertoni Department of Renal Transplantation Careggi University Hospital 50139 FlorenceItaly

Calcineurin inhibitors(CNIs) represent today a cornerstone for the maintenance immunosuppressive treatment in solid organ transplantation. Nevertheless, several attempts have been made either to minimize their dosage or to avoid CNIs at all because these drugs have the severe side effect of chronic nephrotoxicity. This issue represents a frontier for renal transplantation. The principal problem is to understanding whether the poor outcome over the long-term may be ascribed to CNIs nephrotoxicity or to the inability of these drugs to control the acute and chronic rejection B cells mediated. The authors analyze extensively all the international trials attempting to withdraw, minimize or avoid the use of CNIs. Few trials undertaken in low risk patients with an early conversion from CNIs to proliferation signal inhibitors were successful, but the vast majority of trials failed to improve CNIs side effects. To date the use of a new drug, a co-stimulation blocker, seems promising in avoiding CNIs with similar efficacy, better glomerular filtration rate and an improved metabolic profile. Moreover the use of this drug is not associated with the development of donorspecific anti-human leukocyte antigen antibodies. Thispoint has a particular relevance, because the failure of CNIs to realize good outcomes in renal transplantation has recently ascribed to their inability to control the acute and chronic rejections B-cell mediated. This paper analyzes all the recent studies that have been done on this issue that represents the real frontier that should be overcome to realize better results over the long-term after transplantation.

关键词： Calcineurin inhibitors nephrotoxicity Calcineurin inhibitors withdrawal Calcineurin inhibitors minimization Calcineurin inhibitors avoidance Donor specific antibodies Antibody mediated rejection New drugs in renal transplantation

Update on hemolytic uremic syndrome:Diagnostic and therapeutic recommendations

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World Journal of Nephrology 2013年第3期2卷 56-76页

作者： Maurizio Salvadori elisabetta Bertoni Renal Unit Careggi HospitalCareggi UniversityFlorence 50139Italy

Hemolytic uremic syndrome(HUS) is a rare disease. In this work the authors review the recent findings on HUS, considering the different etiologic and pathogenetic classifications. New findings in genetics and, in particular, mutations of genes that encode the complement-regulatory proteins have improved our understanding of atypical HUS. Similarly, the complement proteins are clearly involved in all types of thrombotic microangiopathy: typical HUS, atypical HUS and thrombotic thrombocytopenic purpura(TT P). Furthermore, several secondary HUS appear to be related to abnormalities in complement genes in predisposed patients. The authors highlight the therapeutic aspects of this rare disease, examining both "traditional therapy"(including plasma therapy, kidney and kidneyliver transplantation) and "new therapies". The latter include anti-Shiga-toxin antibodies and anti-C5 monoclonal antibody "eculizumab". Eculizumab has been recently launched for the treatment of the atypical HUS, but it appears to be effective in the treatment of typical HUS and in TT P. Future therapies are in phases Ⅰ and Ⅱ. They include anti-C5 antibodies, which are more purified, less immunogenic and absorbed orally and, anti-C3 antibodies, which are more powerful, but potentially less safe. Additionally, infusions of recom-binant complement-regulatory proteins are a potential future therapy.

关键词：溶血性尿毒症综合征治疗方法临床分析肾病

Hepatitis B:Epidemiology and prevention in developing countries

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World Journal of Hepatology 2012年第3期4卷 74-80页

作者： elisabetta Franco Barbara Bagnato Maria Giulia Marino Cristina Meleleo Laura Serino Laura Zaratti Department of Public Health University Tor Vergata PhD Program for Methodologies in Preventive Medicine and Therapy University Tor Vergata Specialization School for Hygiene and Preventive Medicine University Tor Vergata

Hepatitis B virus(HBV)infection is a serious global public health *** infection may be transmitted through sexual intercourse,parenteral contact or from an infected mother to the baby at birth and,if contracted early in life,may lead to chronic liver disease,including cirrhosis and hepatocellular *** the basis of the HBV carrier rate,the world can be divided in 3 regions of high,medium and low *** major concern is about high endemicity countries,where the most common route of infection remains vertical transmission from mother to *** of all pregnant women and passive immunization with human hepatitis B immunoglobulin are not affordable for many developing *** infection rate can be reduced by modifying behavior,improving individual education,testing all blood donations,assuring asepsis in clinical practice and screening all pregnant ***,availability of a safe and efficacious vaccine and adoption of appropriate immunization strategies are the most effective means to prevent HBV infection and its *** unsolved problem for poorest countries,where the number of people currently infected is high,is the cost of the vaccine.A future challenge is to overcome the social and economic hurdles of maintaining and improving a prevention policy worldwide to reduce the global burden of the disease.

关键词： Hepatitis B Developing countries Endemicity Seroprevalence Vaccine

Time for hepatocellular carcinoma immunotherapy:insights for successful clinical applications in this challenging tumor

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Hepatoma Research 2018年第6期4卷 51-65页

作者： Gabriele Missale elisabetta Cariani Laboratory of Viral Immunopathology Unit of Infectious Diseases and HepatologyAzienda Ospedaliero-Universitaria di ParmaParma 43126Italy Toxicology and Advanced Diagnostics Ospedale Civile S.Agostino-EstenseModena 41126Italy

The multiplicity and phenotype of intratumoral immune infiltrate have been shown to influence the clinical outcome of hepatocellular carcinoma (HCC), thus providing a strong rationale to therapeutic interventions aimed at restoring the dysfunctional immune response against the tumor. Improving the knowledge of the complex interactions between transformed hepatocytes, nonparenchymal resident cells, and infiltrating immune cells (characterizing the HCC microenvironment) will be instrumental to increase the success rate of existing immunotherapeutic strategies and to identify new potential targets for intervention or biomarkers to optimize the selection of candidate patients.

关键词： Hepatocellular carcinoma immune checkpoint inhibitors T lymphocytes cytotoxic T lymphocytes natural killer cells macrophages cytokines

Pelvic muscle floor rehabilitation as a therapeutic option in lifelong premature ejaculation： long-term outcomes

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Asian Journal of Andrology 2018年第6期20卷 572-575页

作者： Antonio Luigi Pastore Giovanni Palleschi Andrea Fuschi Yazan AI Salhi Alessandro Zucchi Giorgio Bozzini Ester Illiano elisabetta Costantini Antonio Carbone Uroiogy Unit Department of Medico-Surgical Sciences and Biotechnologies ICOT Faculty of Pharmacy and Medicine 'Sapienza' University of Rome Latina (LT) 04100 Italy Uroresearch Nonprofit Association for Research in Urology Latina 04100 Italy Department of Urology and Andrology University of Perugia Perugia 05156 Italy Department of Urology MATER DOMINI Humanitas Castellanza (VA) 21053 Italy

The aim of the study was to evaluate the long-term outcomes of pelvic floor muscle （PFM） rehabilitation in males with lifelong premature ejaculation （PE）, using intravaginal ejaculatory latency time （IELT） and the self-report Premature Ejaculation Diagnostic Tool （PEDT） as primary outcomes. A total of 154 participants were retrospectively reviewed in this study, with 122 completing the training protocol. At baseline, all participants had an IELT 〈60 s and PEDT score 〉11. Participants completed a 12-week program of PFM rehabilitation, including physio-kinesiotherapy treatment, electrostimulation, and biofeedback, with three sessions per week, with 20 min for each component completed at each session. The effectiveness of intervention was evaluated by comparing the change in the geometric mean of IELT and PEDT values, from baseline, at 3, 6, and 12 months during the intervention, and at 24 and 36 months postintervention, using a paired sample 2-tailed t-test, including the associated 95% confidence intervals. Of the 122 participants who completed PFM rehabilitation, 111 gained control of their ejaculation reflex, with a mean IELT of 161.6 s and PEDT score of 2.3 at the 12-week endpoint of the intervention, representing an increase from baseline of 40.4 s and 17.0 scores, respectively, for IELT and PEDT （P 〈 0.0001）. Of the 95 participants who completed the 36-month follow-up, 64% and 56% maintained satisfactory eiaculation control at 24 and 36 months oostintervention, respectively.

关键词： biofeedback electrostimulation intravaginal ejaculatory latency time pelvic floor rehabilitation premature ejaculation premature ejaculation diagnostic tool

Diet in neurogenic bowel management:A viewpoint on spinal cord injury

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World Journal of Gastroenterology 2020年第20期26卷 2479-2497页

作者： Marco Bernardi Anna Lucia Fedullo elisabetta Bernardi Diego Munzi Ilaria Peluso Jonathan Myers Florigio Romano Lista Tommaso Sciarra Department of Physiology and Pharmacology"V.Erspamer" Sapienza University of RomeRome 00185Italy Italian Paralympic Committee Rome 00191Italy Federazione Italiana Pallacanestro In Carrozzina(FIPIC) Rome 00188Italy Department of Biosciences Biotechnologies and BiopharmaceuticsUniversity of Bari"Aldo Moro"Bari 70121Italy Joint Veteran Center Scientific DepartmentArmy Medical CenterRome 00184Italy Research Centre for Food and Nutrition Council for Agricultural Research and Economics(CREA-AN)Rome 00178Italy VA Palo Alto Health Care System and Stanford University Cardiology DivisionPalo AltoCA 94025United States Scientific Department Army Medical CenterRome 00184Italy

The aim of this review is to offer dietary advice for individuals with spinal cord injury(SCI)and neurogenic bowel *** this in mind,we consider health conditions that are dependent on the level of lesion including skeletal muscle atrophy,autonomic dysreflexia and neurogenic *** addition,SCI is often associated with a sedentary lifestyle,which increases risk for osteoporosis and diseases associated with chronic low-grade inflammation,including cardiovascular and chronic kidney *** Mediterranean diet,along with exercise and dietary supplements,has been suggested as an anti-inflammatory intervention in individuals with ***,individuals with chronic SCI have a daily intake of whole fruit,vegetables and whole grains lower than the recommended dietary allowance for the general *** studies have reported an increase in neurogenic bowel dysfunction symptoms after high fiber intake;therefore,this finding could explain the low consumption of plant *** consumption of fibre induces dysbiosis,which is associated with bothendotoxemia and *** can be reduced by exercise and diet in individuals with ***,to summarize our viewpoint,we developed a Mediterranean diet-based diet and exercise pyramid to integrate nutritional recommendations and exercise *** guidelines come from previously suggested recommendations for military veterans with disabilities and individuals with SCI,chronic kidney diseases,chronic pain and irritable bowel *** also considered the recent exercise guidelines and position stands for adults with SCI to improve muscle strength,flexibility and cardiorespiratory fitness and to obtain cardiometabolic ***,dietary advice for Paralympic athletes is suggested.

关键词： Neurogenic bowel dysfunction Body composition Mediterranean diet Food–drug interactions Microbiota Paralympic athletes

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World Journal of Transplantation 2016年第4期6卷 632-645页

作者： Maurizio Salvadori elisabetta Bertoni Department of Renal Transplantation Careggi University Hospital

The recurrence of renal disease after renal transplantation is becoming one of the main causes of graft loss afterkidney transplantation. This principally concerns some of the original diseases as the atypical hemolytic uremic syndrome(HUS), the membranoproliferative glomerulonephritis(MPGN), in particular the MPGN now called C3 glomerulopathy. Both this groups of renal diseases are characterized by congenital(genetic) or acquired(autoantibodies) modifications of the alternative pathway of complement. These abnormalities often remain after transplantation because they are constitutional and poorly influenced by the immunosuppression. This fact justifies the high recurrence rate of these diseases. Early diagnosis of recurrence is essential for an optimal therapeutically approach, whenever possible. Patients affected by end stage renal disease due to C3 glomerulopathies or to atypical HUS, may be transplanted with extreme caution. Living donor donation from relatives is not recommended because members of the same family may be affected by the same gene mutation. Different therapeutically approaches have been attempted either for recurrence prevention and treatment. The most promising approach is represented by complement inhibitors. Eculizumab, a monoclonal antibody against C5 convertase is the most promising drug, even if to date is not known how long the therapy should be continued and which are the best dosing. These facts face the high costs of the treatment. Eculizumab resistant patients have been described. They could benefit by a C3 convertase inhibitor, but this class of drugs is by now the object of randomized controlled trials.

关键词： Kidney disease recurrence Complement dysregulation Atypical hemolytic uremic syndrome C3 glomerulopathies Dense deposit disease Plasma therapy Eculizumab C3 glomerulonephritis