检索结果-南通市图书馆

Is precision medicine for colorectal liver metastases still a utopia?New perspectives by modern biomarkers,radiomics,and artificial intelligence

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2022年第6期28卷 608-623页

作者： luca viganò Visala S Jayakody Arachchige Francesco Fiz Department of Hepatobiliary and General Surgery IRCCS Humanitas Research HospitalRozzano 20089MIItaly Department of Biomedical Sciences Humanitas UniversityPieve Emanuele 20072MIItaly Nuclear Medicine IRCCS Humanitas Research HospitalRozzano 20089MIItaly

The management of patients with liver metastases from colorectal cancer is still *** therapeutic options and treatment strategies are available for an extremely heterogeneous clinical *** prediction of patients’outcomes and of the effectiveness of chemotherapy and loco-regional treatments are crucial to reach a precision medicine *** has been an unmet need for a long time,but recent studies have opened new *** morphological biomarkers have been *** dynamic evaluation of the metastases across a time interval,with or without chemotherapy,provided a reliable assessment of the tumor *** have been explored and,thanks to their strong association with prognosis,have the potential to drive treatment *** liver-tumor interface has been identified as one of the main determinants of tumor progression,and its components,in particular the immune infiltrate,are the focus of major *** mining and analyses provided new insights on tumor biology and are expected to have a relevant impact on clinical *** intelligence is a further step *** present paper depicts the evolution of clinical decision-making for patients affected by colorectal liver metastases,facing modern biomarkers and innovative opportunities that will characterize the evolution of clinical research and practice in the next few years.

关键词： Colorectal liver metastases Biomarkers Genetics Immune infiltrate Radiomics Artificial Intelligence

Non-alcoholic fatty liver disease,non-alcoholic steatohepatitis,metabolic syndrome and hepatocellular carcinoma——a composite scenario

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Hepatobiliary Surgery and Nutrition 2018年第2期7卷 130-133页

作者： luca viganò Ana Lleo Alessio Aghemo Division of Hepatobiliary and General Surgery Department of SurgeryHumanitas Clinical and Research CenterHumanitas UniversityRozzanoMilanItaly Department of Biomedical Sciences Humanitas UniversityRozzanoMilanItaly Division of Internal Medicine and Hepatology Department of Internal MedicineHumanitas Clinical and Research CenterHumanitas UniversityRozzanoMilanItaly

Hepatocellular carcinoma(HCC)is the fifth most common cancer and the second leading cause of cancer-related death *** data suggest that the epidemiology of HCC is changing;while the frequencies of hepatitis B virus(HBV)-and hepatitis C virus(HCV)-related HCC are progressively decreasing owing to the development of nucleo(t)side-based therapies and directly acting antiviral agents,respectively,the frequency of cryptogenic HCC continues to increase(15–30%of cases)(1).The rise of cryptogenic HCC is mainly related to non-alcoholic fatty liver disease(NAFLD)(1,2).NAFLD encompasses a wide spectrum of liver injuries,ranging from steatosis to non-alcoholic steatohepatitis(NASH),which may progress to cirrhosis(1,3).

关键词： epidemiology liver NAFLD death

Treatment strategy for colorectal cancer with resectable synchronous liver metastases:Is any evidence-based strategy possible?

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Hepatology 2012年第8期4卷 237-241页

作者： luca viganò Department of HPB and Digestive Surgery Ospedale Mauriziano "Umberto I"Torino 10128Italy

Fifteen percent to twenty-five percent of patients affected by colorectal cancer presents with liver metastases at diagnosis. In resectable cases, surgery is the only potentially curative treatment and achieves survival rates up to 50% at 5 years. Management is complex, as colorectal resection, liver resection, chemotherapy, and, in locally advanced mid/low rectal tumors, radiotherapy have to be integrated. Modern medical practice usually relies on evidence-based protocols. Levels of evidence for synchronous metastases are poor:published studies include few recent prospective series and several retrospective analyses collecting a limited number of patients across long periods of time. Data are difficult to be generalized and are mainly representative of single centre's experience, biased by local recruitment, indications and surgical technique. In this context, surgeons have to renounce to "evidence-based medicine" and to adopt a sort of "experience-based medicine". Anyway, some suggestions are possible. Simultaneous colorectal and liver resection can be safely performed whenever minor hepatectomies are planned, while a case-by-case evaluation is mandatory in case of more complex procedures. Neoadjuvant chemotherapy is preferentially scheduled for patients with advanced metastatic tumors to assess disease biology and to control lesions. It can be safely performed with primarytumor in situ , even planning simultaneous resection at its end. Locally advanced mid/low rectal tumor represents a further indication to neoadjuvant therapies, even if treatment's schedule is not yet standardized. In summary, several issues have to be solved, but every single HPB centre should define its proper strategy to optimize patient's selection, disease control and safety and completeness of surgery.

关键词： Synchronous liver metastases Colorectal liver metastases Liver surgery Simultaneous colorectal and liver resection Preoperative chemotherapy Up-front chemotherapy Neoadjuvant chemo-radiotherapy Locally advanced rectal cancer Survival

Surgical treatment of synchronous colorectal liver and lung metastases： the usefulness of thoracophrenolaparotomy for single stage resection

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Hepatobiliary & Pancreatic Diseases International 2016年第2期15卷 216-219页

作者： Daniele Del Fabbro Marco Alloisio Fabio Procopio Matteo Cimino Matteo Donadon Angela Palmisano luca viganò Guido Torzilli Department of Hepatobiliary Surgery Humanitas Research HospitalUniversity of Milan School of MedicineRozzanoMilanItaly Department of Thoracic Surgery Humanitas Research HospitalUniversity of Milan School of MedicineRozzanoMilanItaly

When suitable, surgery still remains the therapeutic option to be preferred for patients carrier of colorectal liver and lung metastases. Since thoracophrenolaparotomy should be helpful during liver resection for some of these patients, simultaneous removal of right lung metastases can be proposed through this approach. Eleven consecutive patients（median age of 53 years） carrier of colorectal liver and lung metastases, underwent single session surgical resection of both liver and right lung lesions by means of J-shaped thoracophrenolaparotomy. The median number of liver metastases removed was 5（range 2-30） and of lung metastases removed was 2（range 1-3）. Lung metastases were located in the upper lobe in 1 patient, in the middle lobe in 2, in the lower lobe in 6, and in the upper and lower lobe in 2. Mortality and major morbidity were nil. Two patients had a minor morbidity： one had wound infection and bile leakage treated conservatively and the other had transient fever. Mean overall survival was 24.4 months. An aggressive surgical approach should be undertaken for colorectal metastases： in case of multifocal liver disease with complex presentations, J-shaped thoracophrenolaparotomy could be considered as safe approach for combined liver and right lung metastasectomies.

关键词： colorectal carcinoma liver metastases lung metastases thoracophrenolaparotomy

维普期刊数据库

Extreme Cities and Bad Places

在线全文

学校读者我要写书评

暂无评论

International Journal of Disaster Risk Science 2012年第1期3卷 3-10页

作者： Paola viganò Department of Urbanism University IUAV of Venice(Istituto Universitario di Architettura di Venezia)30125 VeniceItaly

This article considers places where climate change-induced hazards will be particularly important,focusing on two examples,the lagoon location of Venice and the Garonne riverbank location of Bordeaux. The Venice lagoon territory is close to the coast and has a dispersed form of urban development. Our project experiments resulted in the formulation of a series of adaptation strategies to increased disaster risks,including returning current agricultural land and residential areas to their original state as wetlands and marshes before their reclamation during the early decades of the twentieth century. The scenarios introduce space as a relevant variable into the debate about the impact of climate change and adaptation. This article also deals with the recovery of “bad places,” such as the urban blight on the Garonne riverbanks of Bordeaux,and their relationship with sustainability and disaster risks. Increasingly,the emphasis on minimizing energy consumption and promoting recycling forces cities to reuse places of elevated risk. Only very recently in modern urban planning are polluted and risky areas frequently selected for new development projects to reclaim the vast areas of existing brownfields in the name of sustainability. Integrating disaster risk reduction into a new economic and social context has thus become an extremely important part of contemporary urban design and planning for these reclaimed(bad) areas. The research concludes that urban and territorial design should and can integrate the inevitability of risk. This is necessary for developing approaches and strategies that offer some rethinking about “wicked” problems,long-term time horizons,radical imagination,dynamic representations,and minute territorial readings in contemporary urban planning.

关键词： disaster urban contemporary

维普期刊数据库

Disaster and Urbanism

在线全文

学校读者我要写书评

暂无评论

International Journal of Disaster Risk Science 2012年第1期3卷 1-2页

作者： Yan Guo Paola viganò Bernardo Secchi Peijun Shi 不详

This special issue of the International Journal of Disaster Risk Science on Disaster and Urbanism shares our empirical research and conceptual contribution to the discussion of risk,disaster,and war and conflict from the perspective of urbanism or urban *** contributing to the emerging study of extreme urban conditions,the special issue engages urbanism with disaster risk science,crosses geopolitical boundaries,exhibits a variety of sociocultural traditions,and unfolds several transdisciplinary intellectual debates.

关键词： disaster Urban urban

维普期刊数据库

Impact of COVID-19 on inflammatory bowel disease practice and perspectives for the future

在线全文

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2021年第33期27卷 5520-5535页

作者： Chiara viganò Giacomo Mulinacci Andrea Palermo Donatella Barisani Lorena Pirola Maria Fichera Pietro Invernizzi Sara Massironi Division of Gastroenterology and Center for Autoimmune Liver Diseases Department of Medicine and SurgeryUniversity of Milano-BicoccaMonza 20900Italy European Reference Network on Hepatological Diseases San Gerardo HospitalMonza 20900Italy School of Medicine and Surgery University of Milano-BicoccaMonza 20900Italy

Coronavirus disease 2019(COVID-19)is an infectious disease caused by the novel coronavirus severe acute respiratory syndrome coronavirus 2(SARS-CoV-2);since its first description in December 2019,it has rapidly spread to a global *** concerns have been raised concerning patients with inflammatory bowel diseases(IBD),which are chronic autoimmune inflammatory disorders of the gut that frequently require immunosuppressive and biological therapies to control their *** evidence has so far demonstrated that patients with IBD are not at increased risk of contracting severe acute respiratory syndrome coronavirus 2 *** for the general population,the identified risk factors for severe COVID-19 course among IBD patients have been established to be advanced age and the presence of *** with high-dose corticosteroids has also been associated with an increased risk of death in IBD patients with *** on COVID-19 is constantly evolving,with data growing at a rapid *** will guarantee better knowledge and stronger evidence to help physicians in the choice of the best therapeutic approach for each patient,concurrently controlling for the risk of IBD disease under treatment and the risk of COVID-19 adverse outcomes and balancing the ***,the impact of the enormous number of severe respiratory patients on healthcare systems and facilities has led to an unprecedented redeployment of healthcare resources,significantly impacting the care of patients with chronic *** this newly changed environment,the primary aim is to avoid harm whilst still providing adequate *** has been applied and is strongly encouraged for patients without the necessity of infusion therapy and whose conditions are *** severe acute respiratory syndrome coronavirus 2 pandemic has already revolutionized the management of patients with chronic immune-mediated diseases such as *** and indirect

关键词： Inflammatory bowel disease Ulcerative colitis Crohn disease COVID-19 SARS-CoV-2 Autoimmunity

Proteinuria in paediatric patients with human immunodefi ciency virus infection

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Clinical Cases 2013年第1期1卷 13-18页

作者： Vania Giacomet Paola Erba Francesca Di Nello Sonia Coletto Alessandra viganò Gian Vincenzo Zuccotti Department of Paediatrics L Sacco Hospital University of Milan 20157 Milan Italy

In human immunodef iciency virus(HIV)-infected people kidney disease is as an important cause of morbidity and mortality. Clinical features of kidney damage in HIV-infected patients range from asymptomatic microalbuminuria to nephrotic syndrome. The lack of specif ic clinical features despite the presence of heavy proteinuria may mask the renal involvement. Indeed, it is important in HIV patients to monitor renal function to early discover a possible kidney injury. After the introduction of antiretroviral therapy, mortality and morbidity associated to HIV-infection have shown a substantial reduction, although a variety of side effects for longterm use of highly active antiretroviral therapy, including renal toxicity, has emerged. Among more than 20 currently available antiretroviral agents, many of them can occasionally cause reversible or irreversible nephrotoxicity. At now, three antiretroviral agents, i.e., indinavir, atazanavir and tenofovir disoproxil fumarate have a well established association with direct nephrotoxicity. This review focuses on major causes of proteinuria and other pathological f indings related to kidney disease in HIV-infected children and adolescents.

关键词： Human immunodeficiency virus-infection Nephropathy Proteinuria Antiretroviral therapy Children

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Le 20 mai

法语国家与地区研究 2010年第3期 6-8页

作者： Delphine de vigan

La voix traverse le sommeil,oscille à la *** femme caresse les cartes retournées sur la table,elle répète plusieurs fois,sur ce ton de certitude :le 20 mai,votre vie va changer.

关键词： Le 20 mai