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Which octogenarian patients are at higher risk after cholecystectomy for symptomatic gallstone disease? A single center cohort study

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World Journal of Clinical Cases 2022年第24期10卷 8556-8567页

作者： Fabrizio D'Acapito Leonardo Solaini Daniela Di Pietrantonio francesca Tauceri maria Teresa Mirarchi ElenaAntelmi francesca Flamini Alessio Amato Massimo Framarini Giorgio Ercolani Department of General and Oncologic Surgery Morgagni-Pierantoni HospitalAUSL RomagnaForlì47121Italy Department of Medical and Surgical Sciences University of BolognaBologna 40126Italy

BACKGROUND Incidence of gallstones in those aged≥80 years is as high as 38%-53%.The decision-making process to select those oldest old patients who could benefit from cholecystectomy is *** To assess the risk of morbidity of the“oldest-old”patients treated with cholecystectomy in order to provide useful data that could help surgeons in the decision-making process leading to surgery in this *** A retrospective study was conducted between 2010 and *** variables were collected and compared between patients who had postoperative complications.A model was created and tested to predict severe postoperative *** The 269 patients were included in the study(193 complicated).The 9.7%of complications were grade 3 or 4 according to the Clavien-Dindo *** levels were lower in patients who did not have any postoperative *** Society of Anesthesiologists scale 4 patients,performing a choledocholithotomy and bilirubin levels were associated with Clavien-Dindo>2 complications(P<0.001).The decision curve analysis showed that the proposed model had a higher net benefit than the treating all/none options between threshold probabilities of 11%and 32%of developing a severe *** Patients with American Society of Anesthesiologists scale 4,higher level of bilirubin and need of choledocholithotomy are at the highest risk of a severely complicated postoperative *** endoscopic or percutaneous treatments should be considered in this subgroup of octogenarians.

关键词： Cholecystitis Gallstones Choledocholithotomy Elderly Post-operative complications

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Rifabutin as salvage therapy for Helicobacter pylori eradication:Cornerstones and novelties

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World Journal of Gastroenterology 2022年第45期28卷 6356-6362页

作者： Antonia Valeria Borraccino francesca Celiberto maria Pricci Bruna Girardi Andrea Iannone maria Rendina Enzo Ierardi Alfredo Di Leo Giuseppe Losurdo Section of Gastroenterology Department of Emergency and Organ TransplantationUniversity of BariBari 70124Italy THD SpA Correggio 42015Italy

When several Helicobacter pylori eradication treatments fail,guidelines recommend a cultured guided approach;however,culture is not widely ***,a rifabutin based regimen could be the best *** indeed shows a low rate of antibiotic *** is generally used in combination with amoxicillin in a triple therapy,with eradication rates about 80%in third-line *** ideal duration of this therapy should range between 10 and 12 *** with antibiotics other than amoxicillin have demonstrated even better results,such as vonoprazan,which is a type of novel acid suppressor ***,a new formulation of triple therapy in a single capsule is under investigation,which is a field that deserves further *** notes of caution about rifabutin should be *** drug is used to treat tuberculosis or atypical mycobacteria;therefore,before starting a rifabutin-based eradication regimen,Mycobacterium tuberculosis infection should be thoroughly tested,since its use could promote the development of antibiotic resistance,thus affecting its effectiveness against Koch’s ***,some serious side effects must be evaluated before starting any rifabutin-based *** effects include fever,nausea,vomiting and bone marrow *** this reason,full blood count surveillance is required.

关键词： Helicobacter pylori Eradication Rifabutin Antibiotic resistance Rescue therapy Treatment

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Occult Cytomegalovirus Cholangitis and Pancreatic Adenocarcinoma: A Case Report

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Infectious Diseases & Immunity 2023年第3期3卷 140-141页

作者： Antonio Mastroianni Sonia Greco Valeria Vangeli maria Vittoria Mauro francesca Greco Roberto Manfredi Infectious&Tropical Diseases Unit "Annunziata"Hub HospitalAzienda Ospedaliera di CosenzaCosenzaItaly Microbiology&Virology Unit "Annunziata"Hub HospitalAzienda Ospedaliera di CosenzaCosenzaItaly University of Bologna BolognaItaly

A rare case of occult cytomegalovirus(CMV)cholangitis along with an updated literature review is *** patient had not undergone solid organ-bone marrow transplantation and had no chronic autoimmune biliary tract disorder or obvious *** patient had underwent a pyloric-sparing duodenocephalopancreasectomy,and the postoperative histopathologic examination revealed multiple ulcerative lesions and an occult CMV *** copy number of CMV DNA was high(38,000 copies/μg DNA)in common bile duct surgical specimens measured by real-time quantitative polymerase chain *** was not detected in blood and urine samples from the patient after full doses of intravenous ganciclovir and full doses of oral valganciclovir antiviral *** report recapitulates the role of CMV in causing severe cholangiopathy in the absence of obvious immunosuppression or autoimmune disorder of the biliary tract.

关键词： Cholangitis Bile cytomegalovirus-DNA detection Biliary complications Cytomegalovirus

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Relationship between MRI pertusion and clinical severity in multiple sclerosis

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Neural Regeneration Research 2020年第4期15卷 646-652页

作者： maria Marcella Laganà Laura Pelizzari francesca Baglio IRCCS Fondazione Don Carlo Gnocchi

Perfusion alterations within several brain regions have been shown in multiple sclerosis patients using different magnetic resonance imaging(MRI)***,MRI-derived brain perfusion metrics have been investigated in association with multiple sclerosis phenotypes,physical disability,and cognitive ***,a review focused on these aspects is still *** aim was to review all the studies investigating the relationship between perfusion MRI and clinical severity during the last fifteen years to understand the clinical relevance of these *** differences among phenotypes were observed both with 1.5T and 3T scanners,with progressive multiple sclerosis presenting with lower perfusion values than relapsing-remitting multiple sclerosis ***,only 3T scanners showed a statistically significant *** results about the association between MRI-derived perfusion metrics and physical disability scores were ***,the majority of the studies showed that lower brain perfusion and longer transit time are associated with more severe physical disability and worse cognitive performances.

关键词： brain perfusion cerebral blood flow cognition disability magnetic resonance imaging MRI multiple sclerosis phenotypes progressive relapsing remitting

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Antimicrobial approach of abdominal post-surgical infections

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World Journal of Gastrointestinal Surgery 2023年第12期15卷 2674-2692页

作者： Marco Fiore Antonio Corrente Sveva Di Franco Aniello Alfieri maria Caterina Pace francesca Martora Stephen Petrou Claudio Mauriello Sebastiano Leone Department of Women Child and General and Specialized SurgeryUniversity of Campania“Luigi Vanvitelli”Naples 80138Italy Unit of Virology and Microbiology “Umberto I”HospitalNocera Inferiore 84018Italy Department of Emergency Medicine University of California San FranciscoSan FranciscoCA 94143United States Department of General Surgery “Santa Maria delle Grazie”HospitalPozzuoli 80078Italy Division of Infectious Diseases “San Giuseppe Moscati”HospitalAvellino 83100Italy

Abdominal surgical site infections(SSIs)are infections that occur after abdominal *** can be superficial,involving the skin tissue only,or more profound,involving deeper skin tissues including organs and implanted ***,SSIs are large global health problem with an incidence that varies significantly depending on the United Nations’Human Development *** purpose of this review is to provide a practical update on the latest available literature on SSIs,focusing on causative pathogens and treatment with an overview of the ongoing studies of new therapeutic strategies.

关键词： Surgical site infections Multidrug resistance Carbapenem-resistant Enterobacterales Carbapenem-resistant Klebsiella Abdominal post-operative complications Post-surgical infections

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Targeting Wnt signaling at the neuroimmune interface for dopaminergic neuroprotectionJrepair in Parkinson＇s disease

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Journal of Molecular Cell Biology 2014年第1期8卷 13-26页

作者： francesca L'Episcopo Cataldo Tirolo Salvo Caniglia Nuccio Testa maria Concetta Moral~ maria francesca Serapide: Stefano Pluchino Bianca Marchetti OASI Institute for Research and Care on Mental Retardation and Brain Aging (IRCCS) Neuropharmacology Section Via Conte Ruggero 73 94018 Troina Italy Department of Physiolocal Sciences Medical School University of Catania Viale A. Doria 6 95125 Catania Italy Department of Clinical Neurosciences John van Geest Centre for Brain Repair and Wellcome Trust-Medical Research Counci~ Stem Celt Institute University ofCambridge Cambridge CB20PY UK Department of Clinical and Molecular Biomedicine Pharmacology Section Medical School University of Catania Viale A. Doria 6 95125 Catania Italy

During the past three decades, the Wingless-type MMTV integration site (Wnt) signaling cascade has emerged as an essential system regulating multiple processes in developing and adult brain. Accumulating evidence points to a dysregulation of Wnt signaling in major neurodegenerative pathologies including Parkinson's disease (PD), a common neurodegenerative disorder characterized by the progressive loss of midbrain dopaminergic (mDA) neurons and deregulated activation of astrocytes and microglia. This review highlights the emerging link between Wnt signaling and key inflammatory pathways during mDA neuron damage/repair in PD progression. In particular, we summarize recent evidence documenting that aging and neurotoxicant exposure strongly antagonize Wnt/β-catenin signaling in mDA neurons and subventricular zone (SVZ) neuroprogenitors via astrocyte-microglial interactions. Dysregulation of the crosstalk between Wnt/β-catenin signaling and anti-oxidant/anti-inflammatory pathways delineate novel mechanisms driving the decline of SVZ plasticity with age and the limited nigrostriatal dopaminergic self-repair in PD. These findings hold a promise in developing therapies that target Wnt/β-catenin signaling to enhance endogenous restoration and neuronal outcome in age-dependent diseases, such as PD.

关键词： Wnt信号传导神经元损伤帕金森氏病多巴胺神经退行性疾病星形胶质细胞信号通路小胶质细胞

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Mallory-Weiss syndrome from giant gastric trichobezoar: A case report

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World Journal of Gastrointestinal Surgery 2023年第5期15卷 972-977页

作者： Eva Lieto Annamaria Auricchio maria Paola Belfiore Giovanni Del Sorbo Gabriele De Sena Vincenzo Napolitano Alessio Ruggiero Gennaro Galizia francesca Cardella Department of Translational Medical Sciences University of Campania L.VanvitelliNapoli 80138CampaniaItaly Department of Precision Medicine University of Campania L.VanvitelliNapoli 80138CampaniaItaly

BACKGROUND Mallory-Weiss syndrome(MWS),representing a linear mucosal laceration at the gastroesophageal junction,is a quite frequent cause of upper gastrointestinal bleeding,usually induced by habitual *** subsequent cardiac ulceration in this condition is likely due to the concomitance of increased intragastric pressure and inappropriate closure of the gastroesophageal sphincter,collectively inducing ischemic mucosal ***,MWS is associated with all vomiting conditions,but it has also been described as a complication of prolonged endoscopic procedures or ingested foreign *** SUMMARY We described herein a case of upper gastrointestinal bleeding in a 16-year-old girl with MWS and chronic psychiatric distress,the latter of which deteriorated following her parents’*** patient,who was residing on a small island during the coronavirus disease 2019 pandemic lockdown period,presented with a 2-mo history of habitual vomiting,hematemesis,and a slight depressive ***,a huge intragastric obstructive trichobezoar was detected and discovered to be due to a hidden habit of continuously eating her own hair;this habit had persisted for the past 5 years until a drastic reduction in food intake and corresponding weight loss *** relative isolation in her living status without school attendance had worsened her compulsory *** hair agglomeration had reached such enormous dimensions and its firmness was so hard that its potential for endoscopic treatment was judged to be *** patient underwent surgical intervention instead,which culminated in complete removal of the *** According to our knowledge,this is the first-ever described case of MWS due to an excessively large trichobezoar.

关键词： Mallory-Weiss syndrome Upper gastrointestinal bleeding Trichobezoar Ringworm Psychiatric distress Case report

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What we should know about portal vein thrombosis in cirrhotic patients:A changing perspective

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World Journal of Gastroenterology 2012年第36期18卷 5014-5020页

作者： francesca Romana Ponziani maria Assunta Zocco Matteo Garcovich francesca D'Aversa Davide Roccarina Antonio Gasbarrini Internal Medicine and Gastroenterology Policlinico A.GemelliCatholic University of Romelargo A.Gemelli800168 RomeItaly

Portal vein thrombosis(PVT) is one of the most common complications occurring during the natural course of liver *** though PVT is often asymptomatic,the worsening of liver function,an unexpected episode of gastrointestinal bleeding or ascitic decompensation may be landmarks of PVT *** these clinical manifestations,it is debated whether PVT really has an impact on liver cirrhosis natural history or rather represents only one of its *** PVT development should not only be considered as a matter of impaired blood flow or pro-coagulation *** one hand,PVT seems a consequence of the worsening in portal vein outflow due to the increased hepatic resistance in cirrhotic *** the other hand,vascular microthrombosis secondary to necroinflammation may cause liver ischemia and infarction,with loss of hepatic tissue(parenchymal extinction) which is replaced by fibrotic ***,PVT might also be considered as the overt manifestation of the liver fibrosing process evolution and anticoagulant therapy may thus have microscopic indirect effects also on the progression of liver *** present,a connection between PVT development and the progression of liver fibrosis/cirrhosis has not yet been ***,it is not clear if PVT development may worsen cirrhotic patients' outcome by *** authors tried to assess liver transplant benefit in PVT cirrhotic patients but data are *** this review,we will try to answer these questions,providing a critical analysis of data reported in literature.

关键词：血栓形成肝硬化门静脉患者肝纤维化 PVT 抗凝血剂标志性建筑

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Clinical and epidemiological features of ulcerative colitis patients in Sardinia,Italy:Results from a multicenter study

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World Journal of Clinical Cases 2022年第30期10卷 10921-10930页

作者： Salvatore Magrì Mauro Demurtas maria francesca Onidi Marcello Picchio Walter Elisei Manuela Marzo Federica Miculan Roberto Manca maria Pina Dore Bianca maria Quarta Colosso Antonio Cicu Luigi Cugia Monica Carta Laura Binaghi Paolo Usai mariantonia Lai Fabio Chicco Massimo Claudio Fantini Alessandro Armuzzi Giammarco Mocci Department of Medical Sciences and Public Health University of CagliariMonserrato 09042Italy Endoscopy Unit Humanitas Istituto Clinico CataneseCatania 95045Italy Endoscopy Unit San Martino HospitalOristano 09170Italy Gastroenterology Unit Brotzu HospitalCagliari 09121Italy Division of General Surgery Ospedale Civile P ColomboVelletri 00049Italy Gastroenterology Unit San Camillo Forlanini HospitalRome 00152Italy Internal Medicine and Gastroenterology Department Cardinale Panico HospitalTricase 73039Italy Department of Surgery San Martino HospitalOristano 09170Italy Division of Gastroenterology Santissima TrinitàHospitalCagliari 09121Italy Dipartimento di Medicina Clinica e Sperimentale University of SassariSassari 07100Italy Department of Medical Science and Public Health University of SassariSassari 07100Italy Unit of Gastroenterology ASL SassariSassari 07100Italy Gastroenterology Unit Santissima Annunziata HospitalSassari 07100Italy Medical Science and Public Health University of CagliariCagliari 09042Italy Medical Sciences and Public health Presidio Policlinico of MonserratoCagliariMonserrato 09042CagliariItaly Department of Internal Medicine University of Rome Tor VergataRome 00133Italy IBD Unit Policlinico Universitario GemelliRome 00168Italy

BACKGROUND There are little data on the epidemiological and clinical features of adult patients with ulcerative colitis(UC) in the different Italian regions,mainly derived from the absence of a national *** prevents correct interpretation of the disease *** To assess the main clinical and epidemiological features of adult patients diagnosed with UC in Sardinia,*** We performed a multicenter,observational,cross-sectional study that included adult patients with UC enrolled in seven gastroenterology unit centers in *** were obtained from the patients’ medical records and from a questionnaire administered at the inclusion *** Four hundred and forty-two patients with UC were *** median age at diagnosis was 39years(interquartile range 28-48).After a median disease duration of 10 years,53 patients experienced proximal extension of proctitis or left-sided ***-five patients developed extraintestinal *** patients(4.3%) developed cancer:two with colorectal cancer and seventeen with extracolonic ***(5-ASA) remains the mainstay of treatment for ***,95 patients(21.5%) were treated with one or more biologic agents,whereas 15 patients(3.4%) underwent surgery,mostly *** Our results provide important insights into the clinical and epidemiological features of patients with UC,and while waiting for a national Italian registry,present eligible data on the UC population in Sardinia.

关键词： Inflammatory bowel disease-basic Inflammatory bowel disease-clinical Ulcerative colitis Epidemiology Natural history Treatment

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Eubiotic properties of rifaximin: Disruption of the traditional concepts in gut microbiota modulation

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World Journal of Gastroenterology 2017年第25期23卷 4491-4499页

作者： francesca Romana Ponziani maria Assunta Zocco francesca D’Aversa Maurizio Pompili Antonio Gasbarrini Internal Medicine Gastroenterology and Hepatology Division Agostino Gemelli Hospital

Antibiotics are usually prescribed to cure infections but they also have significant modulatory effects on the gut microbiota. Several alterations of the intestinal bacterial community have been reported during antibiotic treatment, including the reduction of beneficial bacteria as well as of microbial alpha-diversity. Although after the discontinuation of antibiotic therapies it has been observed a trend towards the restoration of the original condition, the new steady state is different from the previous one, as if antibiotics induced some kind of irreversible perturbation of the gut microbial community. The poorly absorbed antibiotic rifaximin seem to be different from the other antibiotics, because it exerts non-traditional effects additional to the bactericidal/bacteriostatic activity on the gut microbiota. Rifaximin is able to reduce bacterial virulence and translocation, has anti-inflammatory properties and has been demonstrated to positively modulate the gut microbial composition. Animal models, culture studies and metagenomic analyses have demonstrated an increase in Bifidobacterium, Faecalibacterium prausnitzii and Lactobacillus abundance after rifaximin treatment, probably consequent to the induction of bacterial resistance, with no major change in the overall gut microbiota composition. Antibiotics are therefore modulators of the symbiotic relationship between the host and the gut microbiota. Specific antibiotics, such as rifaximin, can also induce eubiotic changes in the intestinal ecosystem; this additional property may represent a therapeutic advantage in specific clinical settings.

关键词：肠的细菌抗菌素 Rifaximin 内脏 microbiota Eubiosis Dysbiosis 毁坏 microbiota 调整

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