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New paradigm of oral rehydration in patients affected by irritable bowel syndrome with chronic diarrhea

World Journal of Gastrointestinal Pharmacology and Therapeutics 2024年第1期15卷 1-4页

作者： Marco Chiarelli matilde de simone Gerardo Cioffi Ugo Cioffi department of Emergency and Robotic Surgery A.Manzoni Hospital–ASST LeccoLecco 23900Italy department of Surgery University of MilanVia F.Sforza 3520122 MilanoMilano 20122Italy department of Sciences and Technologies UnisannioBenevento 82100Italy department of Surgery University of MilanMilano 20122Italy

Irritable bowel syndrome with diarrhea is a very frequent clinical condition characterized by disabling intestinal *** disease presents with daily abdominal pain for at least 3 months related to defecation and associated with a change in the frequency of bowel movements and the shape of the *** surveys about this disease report a global prevalence of about 1.5%.A new amino acid based electrolyte solution has recently been commercialized for oral rehydration in *** is composed of water,electrolytes,and five selected amino acids that function as sodium co-transporters without containing *** recent years,some studies explored the effectiveness of the amino acid based electrolyte beverage in oncologic patients with gastrointestinal mucositis,reporting good ***,a prospective study to evaluate the clinical impact of the amino acid based medical beverage was conducted in patients with diarrhea predominant irritable bowel *** research was based on a real-life methodology minimizing the disruption of the routine *** hundred patients suffering from irritable bowel syndrome with diarrhea drank a solution based on selected amino acids twice a day for 2 *** enrolled patient completed the study and showed a significant response rate with regard to stool consistency and pain *** on this data,we can hypothesize that the amino acid based oral rehydration solution could be a valid tool in the treatment of patients affected by irritable bowel syndrome with *** is certainly necessary to plan highquality clinical trials comparing glucose based oral solutions and amino acid based solutions in patients with persisting *** in the near future all oral rehydration solutions will contain amino acids.

关键词： Diarrhea Irritable bowel syndrome Diarrhea-predominant irritable bowel syndrome Medical food Amino acid beverage formulation

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Left colonic metastasis from primary hepatocellular carcinoma: A case report

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World Journal of Clinical Cases 2019年第15期7卷 2044-2048页

作者： Fulvio Tagliabue Morena Burati Marco Chiarelli Alessandro Marando matilde de simone Ugo Cioffi department of Emergency and Robotic Surgery Ospedale“A Manzoni”Lecco via Dell’Eremo 9/11Lecco 23900Italy department of Pathology Ospedale“A Manzoni”Lecco via Dell’Eremo 9/11Lecco 23900Italy department of Surgery University of MilanMilano 20122Italy

BACKGROUND Hepatocellular carcinoma(HCC)accounts for 5-6%of all human *** the extrahepatic metastasis,the main organs involved are lymphnodes,lung,bone and adrenal *** colon metastasis is very rare,especially on the left sided *** SUMMARY We report a case of a 70 years-old man hepatitis B carrier with HCC treated four times with trans-arterial chemoembolization,presented to our surgical department complaining of gastrointestinal bleeding.A colonoscopy revealed a mass of 4 cm of the sigmoid colon with signs of *** computed tomography showed a mass originated from the sigmoid colon of 3.5 cm,and the presence of HCC in segment VI and VII,without portal vein *** to the large size of the mass and the active bleeding,the patient underwent a left *** postoperative period was uneventful,and the patient was discharged in fifth post-operative *** examination revealed that the neoplasm was characterized by a diffuse proliferation of epithelial cells with an hepatoid ***,the presence of a history of HCC of the liver and the histopathological features supported the diagnosis of metastasis from the *** Although rare,colon metastasis from an HCC can be left-sided and can present with acute bleeding.

关键词： Hepatocellular carcinoma Colon metastasis Case report

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Rethinking the Barcelona clinic liver cancer guidelines:Intermediate stage and Child-Pugh B patients are suitable for surgery?

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World Journal of Gastroenterology 2021年第21期27卷 2784-2794页

作者： Fabrizio Romano Marco Chiarelli Mattia Garancini Mauro Scotti Mauro Zago Gerardo Cioffi matilde de simone Ugo Cioffi department of Surgery School of Medicine and SurgeryUniversity of Milano-BicoccaMonza 20900Italy Emergency and Robotic Surgery A.Manzoni HospitalASST LeccoLecco 23900Italy department of General Surgery San Gerardo HospitalMonza 20900Italy department of Sciences and Technologies Universitàdegli Studi del Sannio di BeneventoBenevento 82100Italy department of Surgery University of MilanMilano 20122Italy

According to Barcelona Clinic Liver Cancer recommendations,intermediate stage hepatocellular carcinomas(stage B)are excluded from liver resection and are referred to palliative ***,Child-Pugh B patients are not usually candidates for liver ***,many hepatobiliary centers in the world manage patients with intermediate stage hepatocellular carcinoma or Child-Pugh B cirrhosis with liver resection,maintaining that hepatic resection is not contraindicated in selected patients with non–early-stage hepatocellular carcinoma and without normal liver *** studies demonstrate that resection provides the best survival benefit for selected patients in very early/early and even in intermediate stages of Barcelona Clinic Liver Cancer classification,and this treatment gives good results in the setting of multinodular,large tumors in patients with portal hypertension and/or Child-Pugh B *** this review we explore this controversial topic,and we show through the literature analysis how liver resection may improve the short-and long-term survival rate of carefully selected Barcelona Clinic Liver Cancer B and Child-Pugh B hepatocellular carcinoma ***,other large clinical studies are needed to clarify which patients with intermediate stage hepatocellular carcinoma are most likely to benefit from liver resection.

关键词： Liver surgery Hepatocellular carcinoma Barcelona liver clinic cancer Child B Intermediate stage

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Robotic vs laparoscopic right colectomy—the burden of age and comorbidity in perioperative outcomes: An observational study

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World Journal of Gastrointestinal Surgery 2020年第6期12卷 287-297页

作者： Fulvio Tagliabue Morena Burati Marco Chiarelli Luca Fumagalli Angelo Guttadauro Elisa Arborio matilde de simone Ugo Cioffi department of Robotic and Emergency Surgery Ospedale A.ManzoniASST LeccoLecco 23900Italy department of Surgery University of Milan-BicoccaIstituti Clinici ZucchiMonza 20900Italy department of Surgery University of MilanMilano 20122Italy

BACKGROUND Several studies have shown the safety,feasibility and oncologic adequacy of robotic right hemicolectomy(RRH).Laparoscopic right hemicolectomy(LRH)is considered technically *** surgery has been introduced to overcome this technical limitation,but it is related to high *** maximize the benefits of such surgery,only selected patients are candidates for this *** addition,due to progressive aging of the population,an increasing number of minimally invasive procedures are performed on elderly patients with severe comorbidities,who are usually more prone to post-operative *** To investigate the outcomes of RRH vs LRH with regard to age and *** We retrospectively analyzed 123 minimally invasive procedures(68 LRHs vs 55 RRHs)for right colon cancer or endoscopically unresectable adenoma performed in our Center from January 2014 until September *** surgical procedures were performed according to standardized *** primary clinical outcome of the study was the length of hospital stay(LOS)measured in *** outcomes were time to first flatus(TFF)and time to first stool *** robotic technique was considered the exposure and the laparoscopic technique was considered the *** demographic variables were obtained,including age at time of surgery and *** mass index and American Society of Anesthesiologists physical status were *** age-adjusted Charlson Comorbidity Index(ACCI)was calculated;the tumornode-metastasis system,intra-operative variables and post-operative complications were ***-operative follow-up was 180 *** LOS,TFF,and time to first stool were significantly shorter in the robotic group:Median 6[interquartile range(IQR)5-8]vs 7(IQR 6-10.5)d,P=0.028;median 2(IQR 1-3)vs 3(IQR 2-4)d,P<0.001;median 4(IQR 3-5)vs 5(IQR 4-6.5)d,P=0.005,*** multivariable analysis,the robotic technique was confirmed to be predictive

关键词： Right hemicolectomy Robotic surgery Laparoscopic surgery Elderly patients Comorbidity Hospital stay

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Paternal physical exercise modulates global DNA methylation status in the hippocampus of male rat offspring

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Neural Regeneration Research 2019年第3期14卷 491-500页

作者： Christiano Spindler Ethiane Segabinazi Andre Luis Ferreira de Meireles Francele Valente Piazza Filipe Mega Gabriela dos Santos Salvalaggio matilde Achaval Viviane Rostirola Elsner simone Marcuzzo Programa de Pos-Graduacao em Neurociencias Instituto de Ciencias Basicas da Saude Universidade Federal do Rio Grande do Sul Laboratorio de Histofisiologia Comparada Departamento de Ciencias Morfologicas Instituto de Ciencias Basicas da Saude Universidade Federal do Rio Grande do Sul Programa de Pos-Graduacao em Biociências e Reabilitacao Centro Universitario Metodista-IPA

It is widely known that maternal physical exercise is able to induce beneficial improvements in offspring cognition; however, the effects of paternal exercise have not been explored in detail. The present study was designed to evaluate the impact of paternal physical exercise on memory and learning, neuroplasticity and DNA methylation levels in the hippocampus of male offspring. Adult male Wistar rats were divided into two groups: sedentary or exercised fathers. The paternal preconception exercise protocol consisted of treadmill running, 20 minutes daily, 5 consecutive days per week for 22 days, while the mothers were not trained. After mating, paternal sperm was collected for global DNA methylation analysis. At postnatal day 53, the offspring were euthanized, and the hippocampus was dissected to measure cell survival by 5-bromo-2′-deoxiuridine and to determine the expression of synaptophysin, reelin, brain-derived neurotrophic factor and global DNA methylation levels. To measure spatial memory and learning changes in offspring, the Morris water maze paradigm was used. There was an improvement in spatial learning, as well as a significant decrease in hippocampal global DNA methylation levels in the offspring from exercised fathers compared with those from sedentary ones; however, no changes were observed in neuroplasticity biomarkers brain-derived neurotrophic factor, reelin and 5-bromo-2′-deoxiuridine. Finally, the global DNA methylation of paternal sperm was not significantly changed by physical exercise. These results suggest a link between paternal preconception physical activity and cognitive benefit, which may be associated with hippocampal epigenetic programming in male offspring. However, the biological mechanisms of this modulation remain unclear.

关键词： epigenetics preconception methylation learning treadmill running fetal programming inheritance sperm nerve regeneration

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ROS and Lipid Droplet accumulation induced by high glucose exposure in healthy colon and Colorectal Cancer Stem Cells

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Genes & Diseases 2020年第4期7卷 620-635页

作者： Luca Tirinato Francesca Pagliari simone Di Franco Elisa Sogne Maria Grazia Marafioti Jeanette Jansen Andrea Falqui matilde Todaro Patrizio Candeloro Carlo Liberale Joao Seco Giorgio Stassi Enzo Di Fabrizio Biomedical Physics in Radiation Oncology DKFZ(German Cancer Research Center)69120 HeidelbergGermany Physical Science and Engineering(PSE)Division King Abdullah University of Science and Technology(KAUST)ThuwalSaudi Arabia department of Experimental and Clinical Medicine University“Magna Graecia”of Catanzaro88100 Loc.GermanetoCatanzaroItaly Biological and Environmental Sciences and Engineering(BESE)Division King Abdullah University of Science and Technology(KAUST)Thuwal 23955-6900Saudi Arabia Cellular and Molecular Pathophysiology Laboratory Department of SurgicalOncological and Stomatological SciencesUniversity of PalermoPalermoItaly Ruprecht Karls University Heidelberg Department of Physics69120 HeidelbergGermany department of Health Promotion Mother and Child CareInternal Medicine and Medical Specialties(PROMISE)University of PalermoPalermoItaly

Lipid Droplets(LDs)are emerging as crucial players in colon cancer development and *** expression has been associated with high tumorigenicity in Cancer Stem Cells(CSCs),so that they have been proposed as a new functional marker in Colorectal Cancer Stem Cells(CR-CSCs).They are also indirectly involved in the modulation of the tumor microenvironment through the production of pro-inflammatory *** is growing evidence that a possible connection between metabolic alterations and malignant transformation exists,although the effects of nutrients,primarily glucose,on the CSC behavior are still mostly *** is an essential fuel for cancer cells,and the connections with LDs in the healthy and CSC populations merit to be more deeply ***,we showed that a high glucose concentration activated the PI3K/AKT pathway and increased the expression of CD133 and CD44v6 CSC ***,glucose was responsible for the increased amount of Reactive Oxygen Species(ROS)and LDs in both healthy and CR-CSC *** also investigated the gene modulations following the HG treatment and found out that the healthy cell gene profile was the most ***,Atorvastatin,a lipidlowering drug,induced the highest mortality on CR-CSCs without affecting the healthy counterpart.

关键词： Cholesterol metabolism Colorectal cancer stem cells Fatty acid

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