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Present concepts in management of atrial fibrillation:From drug therapy to ablation

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World Journal of Cardiology 2009年第1期1卷 11-22页

作者： Giovanni B Forleo luca santini Francesco Romeo Division of Cardiology Department of Internal MedicineUniversity of Rome "Tor Vergata"Viale Oxford8100133 RomeItaly

Atrial fibrillation(AF) management requires knowledge of its pattern of presentation,underlying conditions,and decisions about restoration and maintenance of sinus rhythm,control of the ventricular rate,and antithrombotic *** of sinus rhythm is a desirable goal in AF patients because the prevention of recurrence may improve cardiac function,relieve symptoms and reduce the likelihood of adverse ***-arrhythmic drug therapy is the first-line treatment for patients with paroxysmal and persistent AF based on current ***,currently used drugs have limited efficacy and cause cardiac and extracardiac ***,there is a continued need to develop new drugs,device and ablative approaches to rhythm ***,simpler and safer stroke prevention regimens are needed for AF patients on life-long anticoagulation,including occlusion of the left atrial *** results of the Randomized Evaluation of Long-Term Anticoagulant Therapy study are encouraging in these *** on the pathophysiology of AF is rapidly expanding and identification of focally localized triggers has led to the development of new treatment options for this ***,the clinical decision whether to restore and maintain sinus rhythm or simply control the ventricular rate has remained a matter of intense *** the minority of patients in whom AF cannot be adequately managed by pharmacological therapy,the most appropriate type of non-pharmacological therapy must be selected on an individualized *** treatment of AF with catheter ablation is now a legitimate option for a large number of *** evolution of hybrid therapy,in which two or more different strategies are employed in the same patient,may be an effective approach to management of *** any case,planning a treatment regimen for AF should include evaluation of the risks inherent in the use of various drugs as well as more invasive strategies.

关键词： Antiarrhythmic medications Atrial fibrillation Catheter ablation

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

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

Extreme drought triggers parallel shifts in wood anatomical and physiological traits in upper treeline of the Mediterranean Andes

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Ecological Processes 2024年第1期13卷 132-143页

作者： Luiz santini Jr. Dylan Craven Daigard Ricardo Ortega Rodriguez Manolo Trindade Quintilhan Stephanie Gibson-Carpintero Cristina Aravena Torres Fidel A.Roig Ariel A.Mu?oz Alejandro Venegas-Gonzalez Hémera Centro de Observación de la Tierra Universidad Mayor GEMA Center for Genomics Ecology and Environment Universidad Mayor Data Observatory Foundation ANID Technology Center Depart-ment of Forest Sciences ESALQ-University of Sao Paulo Department of Plant Biology Institute of Biology University of Campinas Instituto de Geografía Universidad Nacional Autónoma de México (UNAM) Argentine Institute of Nivology Glaciology and Environmental Sciences(IANIGLA CONICET ) Institute of Geography Pontificia Universidad Católica de Valparaíso Instituto de Ciencias Agroalimentarias Animales y Ambientales (ICA3) Universidad de O'Higgins

Background Treeline ecotones of Mediterranean ecoregions have been affected by the increasing intensity and severity of droughts. Even though the effect of droughts on forest dynamics has been widely documented, knowledge is relatively scarce of how extreme climate episodes affect the hydraulic structure and, therefore, the phys-iology of woody plants. The Mediterranean Andes have experienced an uninterrupted period of drought since 2010, including an extremely dry year in 2019 with approximately 80% rainfall deficit. Here, we investigated shifts in wood anatomical and physiological traits of Kageneckia angustifolia, an endemic treeline species, in response to this drought *** We evaluated the xylem plasticity of three K. angustifolia populations across their natural distribution(31–35° SL) based on anatomical(vessel structure and distribution) and physiological(intrinsic water-use efficiency) variables in the tree rings. We focused on the period 2000–2020 that corresponds to before the megadrought(2000–2007),(ii) megadrought(2008–2018) and(iii) hyperdrought(2019–2020). The variables were annualized and analyzed by linear mixed-effects *** Our results provide insights to the anatomical and physiological mechanisms underlying the resilience of treeline forests to persistent droughts in central Chile. We found that the extreme drought in 2019–2020 triggered shifts in vessel size and frequency that increased hydraulic safety. These significant shifts in vessel traits occurred in parallel with a decrease in pit aperture area and an increase in water-use efficiency, further increasing the resilience of K. angustifolia to extreme drought *** Our results revealed coordinated shifts in vessel size and frequency and water-use efficiency in response to the megadrought, thereby reducing vulnerability to hydraulic failure. The apparent resilience of K. angustifolia to extreme droughts suggests that this adaptation to drought stress may incre

关键词： Dendro-anatomy Kageneckia angustifolia Xylem vulnerability Drought Climate change

Past and present of cardiocirculatory assist devices: a comprehensive critical review

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Journal of Geriatric Cardiology 2012年第4期9卷 389-400页

作者： Gianluca Rigatelli Francesco santini Giuseppe Faggian Section of Adult Congenital Heart Disease Cardiovascular Diagnosis and Endoluminal Interventions Rovigo General Hospital Viale Tre Martiri 45100 Rovigo Italy Division of Cardiac Surgery University of Verona Medical School Verona Italy

During the last 20 years, the management of heart failure has significantly improved by means of new pharmacotherapies, more timely invasive treatments and device assisted therapies. Indeed, advances in mechanical support, namely with the development of more efficient left ventricular assist devices (LVADs), and the total artificial heart have reduced mortality and morbidity in patients awaiting transplantation, so much so, that LVADs are now approved of as a strategy for destination therapy. In this review, the authors describe in detail the current basic indications, functioning modalities, main limitations of surgical LAVDs, total artificial heart development, and percutaneous assist devices, trying to clarify this complex, but fascinating topic.

关键词： Cardiac surgery Cardiocirculatory support Devices Heart failure Heart transplant

H_(∞)-PID distributed control for output leader-tracking and containment of heterogeneous MASs with external disturbances

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Journal of Control and Decision 2022年第4期9卷 431-444页

作者： Dario Giuseppe Lui Alberto Petrillo Stefania santini Department of Electrical Engineering and Information Technology(DIETI) University of Naples Federico IINaplesItaly

This paper addresses both the output leader-tracking and output containment control prob-lems for heterogeneous linear high-order Multi-Agent Systems(MASs)sharing information over a directed communication topology and subject to external unknown *** solve these control problems,we propose a robust fully distributed Proportional-Integral-Derivative(PID)control strategy,equipped with a filter on the derivative action that allows obtaining both a simpler closed-loop formulation,without the need of the descriptor transformation,and good tracking performances in the case of fast reference signal *** stability analysis is analytically proven via the Lyapunov theory and the H_(∞) *** derived robust stability conditions are expressed as a set Linear Matrix Inequalities(LMIs)whose solution provides the proper tuning of the robust PID control *** simulations confirm the effectiveness and robustness of the proposed approach in solving both the output leader-tracking and output containment control problems.

关键词： Heterogeneous multi-agent systems distributed PID control output containment output leader-tracking robust control

Target therapy in gastrointestinal tract sarcoma:What is new?

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World Journal of Gastrointestinal Oncology 2010年第1期2卷 1-4页

作者： Bruno Vincenzi Anna Maria Frezza Daniele santini Giuseppe Tonini Department of Medical Oncology University Campus Bio-MedicoVia Alvaro del Portillo 200

Soft tissue sarcoma are rare tumors arising mostly from embryonic mesoderm, that can affect almost any part of the human body, including the gastrointestinal tract. The prognosis associated with soft tissue sarcoma is still poor, mainly because of the low efficacy of traditional approaches based on surgery and chemotherapy. As a result of genetic and molecular analysis, several new target therapies have been developed, leading to a significant improvement in the survival of patients affected by advanced disease. In this review we aim to explore the therapeutic potential and benefit of target therapy in the management of gastrointestinal soft tissue sarcoma and the possible complications or pitfalls of such an approach.

关键词： Soft tissue sarcoma Target therapy Angiogenesis

Isolated repeated anastomotic recurrence after sigmoidectomy

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World Journal of Gastroenterology 2014年第43期20卷 16343-16348页

作者： Giovanni Conzo Claudio Mauriello Claudio Gambardella Fabio Cavallo Ernesto Tartaglia Salvatore Napolitano Luigi santini Department of Anaesthesiologic Surgical and Emergency ScienceⅦ Division of General SurgerySecond University of Naples80131 NaplesItaly

Repeated anastomotic recurrence(AR)of colonic cancer is *** report a case of a double-isolated AR after *** 2003,a 60-year-old woman underwent stapled sigmoid resection for a moderately differentiated *** rectal bleeding occurred after six months,and colonoscopy detected an ***,an additional stapled colorectal anastomosis was *** months later,a colonoscopy detected a circumferential AR that prompted the completion of a second colorectal resection,with a doublestapled colorectal ***-four hours after surgery,a massive pulmonary embolism occurred,and the patient died within a few *** present,onlysix cases of repeated isolated AR have been *** segmental colorectal resections are generally associated with a favourable prognosis,with a median survival rate of 45 mo(range,13-132 mo).Repeated isolated ARs are rare,and segmental colorectal resections are generally associated with long-term diseasefree survival.

关键词： Repeated Anastomotic Recurrence Stapled Anastomosis Viable Exfoliated Cells

Online Edutainment Videos Recontextualizing and Reconceptualizing Expert Discourse in a Participatory Web-culture

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Journalism and Mass Communication 2015年第2期5卷 51-63页

作者： Laura santini University of Genoa Genoa Italy

The online world is becoming more and more edutainment, where learning, getting informed and entertained seem to be part of one and the same activity. As a result of this current fascination, people are drawn increasingly towards a new genre, i.e. free online 20-minute long lectures that borrow from film and storytelling techniques, that are offering an engaging series of speeches and even courses in many different scientific subjects. Though English as a lingua franca is still the dominant language of the internet, as a result of a growing new trend, namely crowdsourcing translation, knowledge dissemination is further enhanced and is now reaching further into many different cultures, allowing even the so-called minor languages to regain dignity and circulate, by engaging native speakers from different cultural backgrounds. This paper offers an overview on the phenomenon of online edutainment considering the role played by collaborative users who not only enjoy but also create and translate content. In addition, a case study focused on TED Talks allows a more in depth analysis of the new genre and the increasing need for subtitling scripts.

关键词： knowledge dissemination expert discourse TED Talks edutainment MOOCs