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Transjugular intrahepatic portosystemic shunt for a patient with chylothorax in cryptogenic/metabolic cirrhosis

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Hepatobiliary & Pancreatic Diseases International 2020年第3期19卷 303-304页

作者： Francesco Cocomazzi Nicola Maurizio Castellaneta Antonino Castellaneta Fabio Fucilli enzo Ierardi Alfredo Di Leo Section of Gastroenterology Department of Emergency and Organ TransplantationUniversity of BariBariItaly Radiology Unit IRCCS De BellisCastellana GrotteBariItaly

To the Editor:Chylothorax is a rare pleural effusion with a milky appearance due to triglycerides and chylomicrons[1];About 1%of cases are associated with liver cirrhosis[2].Incidentally,it has been hypothesized that chylothorax originates from the passage of chylous ascites into pleural cavity owing to diaphragmatic defects and negative thoracic pressure[3].Chylous ascites represents the 1%of ascites in liver cirrhosis(1:20,000 hospitalizations)[4].Pathophysiological mechanism is mediated by increased hepatic and gastrointestinal lymphatic flow due to portal hypertension[5]。

关键词： cirrhosis ascites pleural

Probiotic monotherapy and Helicobacter pylori eradication: A systematic review with pooled-data analysis

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World Journal of Gastroenterology 2018年第1期24卷 139-149页

作者： Giuseppe Losurdo rossella Cubisino Michele Barone Mariabeatrice Principi Gioacchino Leandro enzo Ierardi Alfredo Di Leo Section of Gastroenterology Department of Emergency and Organ TransplantationUniversity "Aldo Moro"Piazza Giulio Cesare National Institute of Gastroenterology "S De Bellis" Research Hospital

AIM To define probiotic monotherapy effect on Helicobacter pylori(H. pylori) status by performing a systematic *** Methods of analysis and inclusion criteria were based on PRISMA recommendations. Relevant publications were identified by searching Pub Med, MEDLINE, Science Direct, and EMBASE. The end-point was to estimate eradication rate and urea breath test delta value before and after probiotic monotherapy across all studies and, overall, with a pooled data analysis. Adverse events of probiotic therapy were evaluated. The data were expressed as proportions/percentages, and 95%CIs were calculated. For continuous variables, we evaluated the weighted mean difference. Odd ratios(ORs) were calculated according to the Peto method for the comparison of eradication rates between probiotics and *** Eleven studies were selected. Probiotics eradicated H. pylori in 50 out of 403 cases. The mean weighted eradication rate was 14%(95%CI: 2%-25%, P =0.02). Lactobacilli eradicated the bacterium in 30 out of 235 patients, with a mean weighted rate of 16%(95%CI: 1%-31%). Saccharomyces boulardii achieved eradication in 6 out of 63 patients, with a pooled eradication rate of 12%(95%CI: 0%-29%). Multistrain combinations were effective in 14 out of 105 patients, with a pooled eradication rate of 14%(95%CI: 0%-43%). In the comparison of probiotics vs placebo, we found an OR of 7.91 in favor of probiotics(95%CI: 2.97-21.05, P < 0.001). Probiotics induced a mean reduction in delta values higher than placebo(8.61% with a 95%CI: 5.88-11.34, vs 0.19% for placebo, P < 0.001). Finally, no significant difference in adverse events was found between probiotics and placebo(OR = 1, 95%CI: 0.06-18.08).CONCLUSION Probiotics alone show a minimal effect on H. pylori clearance, thus suggesting a likely direct role.

关键词： Helicobacter pylori probiotics eradication meta-analysis breath test

Optimizing proton pump inhibitors in Helicobacter pylori treatment:Old and new tricks to improve effectiveness

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World Journal of Gastroenterology 2019年第34期25卷 5097-5104页

作者： enzo Ierardi Giuseppe Losurdo Rosa Federica La Fortezza Mariabeatrice Principi Michele Barone Alfredo Di Leo Section of Gastroenterology Department of Emergency and Organ Transplantation University of Bari

The survival and replication cycle of Helicobacter pylori(***)is strictly dependant on intragastric pH,since *** enters replicative phase at an almost neutral pH(6-7),while at acid pH(3-6)it turns into its coccoid form,which is resistant to *** these bases,it is crucial to increase intragastric pH by proton pump inhibitors(PPIs)when an antibiotic-based eradicating therapy needs to be ***,several tricks need to be used to optimize eradication rate of different *** administration of the highest dose as possible of PPI,by doubling or increasing the number of pills/day,has shown to be able to improve therapeutic outcome and has often proposed in rescue therapies,even if specific trials have not been performed.A pre-treatment with PPI before starting antibiotics does not seem to be effective,therefore it is ***,the choice of PPI molecule could have a certain weight,since second-generation substances(esomeprazole,rabeprazole)are likely more effective than those of first generation(omeprazole,lansoprazole).A possible explanation is due to their metabolism,which has been proven to be less dependent on cytochrome P450(CYP)2C19 genetic ***,vonoprazan,a competitive inhibitor of H+/K+-ATPase present on luminal membrane of gastric parietal cells has shown the highest efficacy,due to both its highest acid inhibition power and rapid pharmacologic *** current data come only from Eastern Asia,therefore its strong power needs to be confirmed outside this geographic area in Western countries as well as related to the local different antibiotic resistance rates.

关键词： Helicobacter pylori Proton pump inhibitors Eradication Cytochrome P450 Optimization

Fabrication and Applications of Micro/Nanostructured Devices for Tissue Engineering

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Nano-Micro Letters 2017年第1期9卷 1-13页

作者： Tania Limongi Luca Tirinato Francesca Pagliari Andrea Giugni Marco Allione Gerardo Perozziello Patrizio Candeloro enzo Di Fabrizio SMILEs Lab Physical Science and Engineering(PSE)and Biological and Environmental Sciences and Engineering(BESE)DivisionsKing Abdullah University of Science and TechnologyThuwal 23955-6900Kingdom of Saudi Arabia Department of Biological and Environmental Sciences and Engineering(BESE) King Abdullah University of Science and TechnologyThuwal 23955-6900Kingdom of Saudi Arabia Laboratory of Nanotechnology BioNEM Department of Experimental and Clinical MedicineUniversity"Magna Graecia"of CatanzaroViale Europa-Loc.Germaneto88100 CatanzaroItaly

Nanotechnology allows the realization of new materials and devices with basic structural unit in the range of1–100 nm and characterized by gaining control at the atomic, molecular, and supramolecular level. Reducing the dimensions of a material into the nanoscale range usually results in the change of its physiochemical properties such as reactivity,crystallinity, and solubility. This review treats the convergence of last research news at the interface of nanostructured biomaterials and tissue engineering for emerging biomedical technologies such as scaffolding and tissue regeneration. The present review is organized into three main sections. The introduction concerns an overview of the increasing utility of nanostructured materials in the field of tissue engineering. It elucidates how nanotechnology, by working in the submicron length scale, assures the realization of a biocompatible interface that is able to reproduce the physiological cell–matrix interaction. The second, more technical section, concerns the design and fabrication of biocompatible surface characterized by micro- and submicroscale features, using microfabrication, nanolithography, and miscellaneous nanolithographic *** the last part, we review the ongoing tissue engineering application of nanostructured materials and scaffolds in different fields such as neurology, cardiology, orthopedics, and skin tissue regeneration.

关键词： Nanomaterials Nanostructures Microfabrication Nanofabrication Device Tissue engineering

A geomorphological model of susceptibility to the effect of human interventions for environmental licensing determination(SHIELD)

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Geoscience Frontiers 2022年第2期13卷 284-294页

作者： Cristina I.Pereira Celene B.Milanes Ivan Correa enzo Pranzini Benjamin Cuker Camilo M.Botero EAFIT University Earth Sciences DepartmentMedellínColombia Coastal Systems Research Group Playas Corporation Ltda.BogotáColombia Civil and Environmental Department Universidad De La CostaBarranquillaColombia Department of Earth Sciences University of FlorenceFirenzeItaly Department of Marine and Environmental Science Hampton UniversityHamptonUnited States University Sergio Arboleda School of LawSanta

Almost every country requires some form of environmental licensing prior to the inception of development projects that may affect the integrity of the environment and its social *** developed a new conceptual and methodological model to instruct the assessment of the potential impacts posed by proposed *** to Human Interventions for Environmental Licensing Determination(SHIELD)includes a novel geomorphological interpretation of the Environmental Impact Assessment(EIA).It considers the impact of human interventions on geomorphological processes and landscape functioning in the context of the entire ecosystem,going further than the classical concept of *** susceptibility of the site informs the screening stage,allowing local conditions to help define the criteria used in the ***,the level of detail of the environmental baseline is scoped by considering the degree of disturbance of natural processes posed by human *** this geomorphological susceptibility model on different kinds of environments would allow shifting the environmental licensing practices from the prevailing anthropocentric and static conception of the environment towards an Ecosystem *** addresses the need to improve the screening and scoping stages that form the basis of the rest of any *** introduces several innovations to EIA including the incorporation of fuzzy logic,a preassembled database of contributions form experts,and a shifting of emphasis from the type of proposed intervention to the type of environment and its relative susceptibility.

关键词： Processes and landforms Expert knowledge Ecosystem approach Screening Scoping

A Pioneering Experimental Study on the Batch Crystallization of the Citric Acid Monohydrate

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Journal of Chemistry and Chemical Engineering 2014年第6期8卷 611-620页

作者： enzo Bonacci Department of Mathematics and Physics Scientific High School "G.B. Grassi" of Latina Latina 04100 Italy

Citric acid is an important organic substance whose marketing concerns various fields. Nevertheless, until 1997 the scientific literature reported little information about the process of crystallization by cooling through which the commercial product is obtained. In particular, the available studies were aimed to investigate only the kinetics of nucleation and crystal growth neglecting some effective aspects of the industrial crystallization in mechanically stirred apparatus. In order to fill that sci-tech gap, the Department of Chemical Engineering at the University ＂La Sapienza＂ of Rome decided to lead a long and meticulous experimental research on the crystallization in discontinuous （batch） of CAM （citric acid monohydrate） in the allotropic form that is stable at room temperature. Due to the number of people involved in that pioneering work, carried out in the historic laboratories of＂La Sapienza＂（Faculty of Engineering）, and motivated by the publication of related ***. dissertations and research papers, such collective effort was called ＂School of Industrial Crystallization＂. Among the graduate students in Chemical Engineering that 17 years ago participated in that fruitful experience there was also the author who, under the supervision of Prof. Barbara Mazzarotta, had the specific task of assessing the effects on CAM of changing the crystallization operating conditions until their optimization; the achievements are briefly illustrated in this paper.

关键词： Batch crystallization CAM informative essay crystal size distribution Zwietering correlation.

Hemodynamic management in brain dead donors

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World Journal of Transplantation 2021年第10期11卷 410-420页

作者： Chiara Lazzeri Manuela Bonizzoli Cristiana Guetti Giorgio enzo Fulceri Adriano Peris Intensive Care Unit and Regional ECMO Referral Centre Azienda Ospedaliero Universitaria CareggiFlorence 50134Italy

Donor management is the key in the complex donation process,since up to 20%of organs of brain death donors(DBD)are lost due to hemodynamic *** challenge is made more difficult due to the lack of strong recommendations on therapies for hemodynamic management in DBDs and more importantly to the epidemiologic changes in these donors who are becoming older and with more comorbidities(marginal donors).In the present manuscript we aimed at summarizing the available evidence on therapeutic strategies for hemodynamic management(focusing on vasoactive drugs)and monitoring(therapeutic goals).Evidence on management in elderly DBDs is also *** management continues critical care but with different and specific therapeutic goals since the number of donor goals met is related to the number of organs retrieved and *** monitoring of selected parameters(possibly including serial echocardiography)is the clinical tool able to guarantee the achievement and maintaining of therapeutic *** worldwide differences,norepinephrine is the vasoactive of choice in most countries but,whenever higher doses(>0.2 mcg/kg/min)are needed,a second vasoactive drug(vasopressin)is *** therapy(desmopressin,corticosteroid and thyroid hormone)are suggested in all DBDs independently of hemodynamic *** the single patient,therapeutic regimen(imprimis vasoactive drugs)should be chosen also according to the potential organs retrievable(*** vs liver and kidneys).

关键词： Brain-dead donors Hemodynamic Management Vasoactive drugs Hormanal therapy Echocardiography

Dynamic Characteristics of a Curved Cable-stayed Bridge:Operational Modal Testing and FE Modeling

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施工技术 2010年第5期39卷 111-117页

作者： Bruno Briseghella Fulvio Busatta Carmelo Gentile enzo Siviero Tobia Zordan College of Civil Engineering Fuzhou University Department of Structural Engineering Politecnico di Milano Department of Architectural Construction University IUAV of Venice College ofCivil Engineering Tongji University

This paper summarizes the analytical and experimental dynamic analyses carried out to assess the actual dynamic behaviour of a curved cable-stayed bridge,recently erected in the commercial harbour of Porto Marghera ( Venice,Italy). Ambient vibration tests were carried out to determine the dynamic characteristics of the bridge and more than 20 modes were identified in the frequency range 0～10Hz. In the theoretical study,a 3D FE model of the bridge was developed using an integrated CAD-FEA approach; subsequently,the information obtained from the field tests,combined with simple manual tuning,provided a linear elastic model,accurately fitting the modal parameters of the bridge in its present condition.

关键词：动力学 CAD技术施工技术 3D模型

Role of concomitant therapy for Helicobacter pylori eradication: A technical note

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World Journal of Gastroenterology 2016年第38期22卷 8638-8640页

作者： Giuseppe Losurdo Floriana Giorgio Andrea Iannone Mariabeatrice Principi Michele Barone Alfredo Di Leo enzo Ierardi Section of Gastroenterology Department of Emergency and Organ TransplantationUniversity of Bari

We read with interest the recent meta-analysis by Lin et al who evaluated the effectiveness of concomitant regimen for Helicobacter pylori(H. pylori) in Chinese regions. They found that 7-d concomitant regimen is undoubtedly superior to 7-d triple therapy(91.2% vs 77.9%, P < 0.0001). However, it is a common belief that a triple therapy lasting 7 d should be definitively removed from the clinical practice for its ineffectiveness. Only its prolongation to 14 d may give satisfactory success rate. Thus, the assessment of an old and outdated treatment versus a more recent and successful one does not seem to bring novel and useful information. Moreover, a 7-d duration has not been ascertained for concomitant regimen, as main guidelines recommend a 10-d schedule for this scheme. Therefore, only studies comparing 10-d concomitant versus 14-d triple seem to be appropriate according to current Guidelines and would clarify which regimen is the most suitable worldwide. Additionally, in this metaanalysis concomitant and sequential therapy showed similar performances, despite it is common opinion that sequential is more prone than concomitant therapy to fail when metronidazole resistance occurs, and China is characterized by high rate of resistance to this antibiotic. None of the included studies evaluated a priori antibiotic resistances, and the lack of this detail hampers the unveiling of this apparent contradiction. In conclusion, the lack of the evaluation of the quality of included trials as well as their high heterogeneity constitute a burdensome limit to draw solid conclusions in this meta-analysis. On the bases of these considerations and the low number of examined trials, we believe that further studies and the knowledge of antibiotic resistances will support with high quality evidence which is the best regimen and its optimal duration.

关键词： Helicobacter pylori Eradication Sequential Concomitant Triple therapy Antibiotic resistances