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Aspirin interruption before neurosurgical interventions:A controversial problem

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World Journal of Cardiology 2024年第4期16卷 191-198页

作者： Alexander Kulikov Anton Konovalov pier paolo Pugnaloni Federico Bilotta Department of Anesthesiology Burdenko National Medical Research Center of NeurosurgeryMoscow 125047Russia Department of Vascular Neurosurgery Burdenko National Medical Research Center of NeurosurgeryMoscow 125047Russia Department of Anesthesiology Critical Care and Pain MedicineUniversity of Rome“Sapienza”Rome 00161Italy

Aspirin is widely used for primary or secondary prevention of ischemic *** the same time,chronic aspirin consumption can affect blood clot formation during surgical intervention and increase intraoperative blood *** is especially important for high-risk surgery,including *** European Society of Cardiology guidelines recommend aspirin interruption for at least 7 d before neurosurgical intervention,but this suggestion is not supported by clinical *** narrative review presents evidence that challenges the necessity for aspirin interruption in neurosurgical patients,describes options for aspirin effect monitoring and the clinical implication of these methods,and summarizes current clinical data on bleeding risk associated with chronic aspirin therapy in neurosurgical patients,including brain tumor surgery,cerebrovascular procedures,and spinal surgery.

关键词： Aspirin Neurosurgery Postoperative complications Bleeding risk Brain tumor surgery Cerebrovascular surgery Spinal surgery

Role of glioma stem cells in promoting tumor chemo- and radioresistance: A systematic review of potential targeted treatments

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World Journal of Stem Cells 2024年第5期16卷 604-614页

作者： Edoardo Agosti Marco Zeppieri Mattia Ghidoni Tamara Ius Alessandro Tel Marco Maria Fontanella pier paolo Panciani Division of Neurosurgery Department of Medical and Surgical SpecialtiesRadiological Sciences and Public HealthUniversity of BresciaBrescia 25123Italy Department of Ophthalmology University Hospital of UdineUdine 33100Italy Neurosurgery Unit Department of Head-Neck and NeuroScienceUniversity Hospital of UdineUdine 33100Italy Clinic of Maxillofacial Surgery Department of Head-Neck and NeuroScienceUniversity Hospital of UdineUdine 33100Italy

BACKGROUND Gliomas pose a significant challenge to effective treatment despite advancements in chemotherapy and *** stem cells(GSCs),a subset within tumors,contribute to resistance,tumor heterogeneity,and *** studies reveal GSCs’role in therapeutic resistance,driven by DNA repair mechanisms and dynamic transitions between cellular *** mechanisms can involve different cellular pathways,most of which have been recently reported in the *** progress,targeted therapeutic approaches lack consensus due to GSCs’high *** To analyze targeted therapies against GSC-mediated resistance to radio-and chemotherapy in gliomas,focusing on underlying *** A systematic search was conducted across major medical databases(PubMed,Embase,and Cochrane Library)up to September 30,*** search strategy utilized relevant Medical Subject Heading terms and keywords related to including“glioma stem cells”,“radiotherapy”,“chemotherapy”,“resistance”,and“targeted therapies”.Studies included in this review were publications focusing on targeted therapies against the molecular mechanism of GSC-mediated re-sistance to radiotherapy resistance(RTR).RESULTS In a comprehensive review of 66 studies on stem cell therapies for SCI,452 papers were initially identified,with 203 chosen for full-text *** them,201 were deemed eligible after excluding 168 for various *** temporal breakdown of studies illustrates this trend:2005-2010(33.3%),2011-2015(36.4%),and 2016-2022(30.3%).Key GSC models,particularly U87(33.3%),U251(15.2%),and T98G(15.2%),emerge as significant in research,reflecting their representativeness of glioma *** analysis indicates a focus on phosphoinositide 3-kinase/protein kinase B/mammalian target of rapamycin(mTOR)(27.3%)and Notch(12.1%)pathways,suggesting their crucial roles in resistance *** molecules with mTOR(18.2%),CHK1/2(15.2%),and ATP binding cassette

关键词： Glioma stem cells Chemoresistance Radioresistance Molecular pathways Targeted therapies Systematic review

Current status and future perspectives on stem cell transplantation for spinal cord injury

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World Journal of Transplantation 2024年第1期14卷 189-209页

作者： Edoardo Agosti Marco Zeppieri Andrea Pagnoni Marco Maria Fontanella Alessandro Fiorindi Tamara Ius pier paolo Panciani Division of Neurosurgery Department of Medical and Surgical SpecialtiesRadiological Sciences and Public HealthUniversity of BresciaBrescia 25123Italy Department of Ophthalmology University Hospital of UdineUdine 33100Italy Department of Medical and Surgical Specialties Radiological Sciencesand Public HealthUniversity of BresciaBrescia 25123BSItaly Neurosurgery Unit Head-Neck and NeuroScience DepartmentUniversity Hospital of UdineUdine 33100Italy

BACKGROUND Previous assessments of stem cell therapy for spinal cord injuries(SCI)have encountered challenges and *** research primarily emphasizes safety in early-phase clinical trials,while systematic reviews prioritize effectiveness,often overlooking safety and translational *** situation prompts inquiries regarding the readiness for clinical *** To offer an up-to-date systematic literature review of clinical trial results concerning stem cell therapy for *** A systematic search was conducted across major medical databases[PubMed,Embase,Reference Citation Analysis(RCA),and Cochrane Library]up to October 14,*** search strategy utilized relevant Medical Subject Heading(MeSH)terms and keywords related to"spinal cord","injury","clinical trials","stem cells","functional outcomes",and"adverse events".Studies included in this review consisted of randomized controlled trials and non-randomized controlled trials reporting on the use of stem cell therapies for the treatment of *** In a comprehensive review of 66 studies on stem cell therapies for SCI,496 papers were initially identified,with 237 chosen for full-text *** them,236 were deemed eligible after excluding 170 for various *** studies encompassed 1086 patients with varying SCI levels,with cervical injuries being the most common(42.2%).Bone marrow stem cells were the predominant stem cell type used(71.1%),with various administration ***-up durations averaged around 84.4 *** 32.7%of patients showed functional improvement from American spinal injury association Impairment Scale(AIS)A to B,40.8%from AIS A to C,5.3%from AIS A to D,and 2.1%from AIS B to *** improvements were observed in 30.9%of patients.A relatively small number of adverse events were recorded,including fever(15.1%),headaches(4.3%),muscle tension(3.1%),and dizziness(2.6%),highlighting the potential for SCI recovery with stem cell *** In

关键词： Spinal cord injury Stem cell therapy Adverse events Functional outcomes Systematic review

The reuse of abandoned Acquaresi mine voids for storage of the Masua flotation tailings

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International Journal of Coal Science & Technology 2014年第2期1卷 213-220页

作者： pier paolo Manca paolo Desogus Giampaolo Orru DICAAR Department of Civil EngineeringEnvironmental and ArchitectureUniversity of CagliariCagliariItaly

Often in abandoned mine sites are present both underground voids produced by mining and the tailings of treatment *** interesting solution for the rehabilitation of the sites would be to place the tailings of the process in the underground mining voids,thus obtaining the reclamation of surface areas and the stabilization of abandoned voids to prevent the dangerous phenomena of ***,these operations require inert waste,which must not be source of pollution,and the choice of a water/solid optimum to ensure good conditions of pumpability.

关键词： Acquaresi mine Mine voids Masua Flotation tailings

Congenital Absence of Pericardium:The Largest Systematic Review in the Field on 247 Worldwide Cases(1977-Now)

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Congenital Heart Disease 2023年第6期18卷 595-610页

作者： pier paolo Bassareo Aurelio Secinaro paolo Ciliberti Massimo Chessa Marco Alfonso Perrone Kevin Patrick Walsh Colin Joseph Mcmahon Mater Misericordiae University Hospital National Adult Congenital Heart Disease ServiceDublinD07 R2WYIreland Children’s Health Ireland Crumlin DublinIreland School of Medicine University College of DublinDublinIreland Advanced Cardiovascular Imaging Unit Bambino GesùChildren’s HospitalIRCCSRomeItaly Department of Cardiac Surgery CardiologyHeart and Lung Transplantation Bambino Gesu’Children’s HospitalIRCCSRomeItaly Adult Congenital Heart Disease UNIT Paediatric and Adult Congenital Heart CentreIRCCS-Policlinico San DonatoSan Donato MilaneseMilanItaly School of Medicine Vita Salute San Raffaele UniversityMilanItaly Division of Cardiology and CardioLab Department of Clinical Sciences and Translational MedicineUniversity of Rome Tor VergataRomeItaly

Background:Congenital absence of pericardium(CAP),also known as pericardial agenesis,represents an uncommon cardiac abnormality and mostly incidental *** can be subdivided into complete and partial(left or right-sided)*** of its infrequency,just case reports and a few case series have been released so *** paper represents the largest systematic review in the *** features(age at diagnosis,type,gender,clinical presentation,electrocardiography,imaging(ultrasounds,CT/MRI),concomitant cardiac defects,and outcome)were ***:The electronic database PubMed was investigated from its establishment up to July 15th,*** case reports and case series were *** studies,papers that were not in English,Spanish,and Italian,and those manuscripts not reporting at least seven of the nine analysed *** ruled *** analysed data were reported mostly in terms of ***:One hundred eighty studies were included encompassing 247 *** than half of reviewed CAP cases were in males(63.2%).The mean age at diagnosis was 31.8±19.3 years;a range of 32 weeks of gestation-81 years).23.5%of the patients did not report any *** most common clinical presentations were chest pain(35.2%)and dyspnoea(29.2%).The most commonly seen ECG changes were right axis deviation(28.7%)and right bundle branch block(23.9%).CAP was suspected or diagnosed by echocardiography in 20.1%of *** diagnosis was made by CT and/or MRI in 61.9%of *** was left-sided in 71.2%,complete in 23.1%,and right-sided in 5.7%.A concomitant congenital heart defect was found in 22.7%,especially in the form of atrial septal defect(6.5%)and patency of ductus arteriosus(2.8%).The pericardial repair was required in 12.9% of the incomplete forms of the *** did the complete form require surgical *** outcome appeared favourable in the vast majority of cases,with just 18 deaths(7.3%).Discussion:The main limitation of this syste

关键词： Congenital absence pericardium pericardial agenesis electrocardiography echocardiography computed tomography cardiac magnetic resonance imaging

Radiomics and machine learning applications in rectal cancer:Current update and future perspectives

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World Journal of Gastroenterology 2021年第32期27卷 5306-5321页

作者： Arnaldo Stanzione Francesco Verde Valeria Romeo Francesca Boccadifuoco pier paolo Mainenti Simone Maurea Department of Advanced Biomedical Sciences University of Naples"Federico II"Naples 80131Italy Institute of Biostructures and Bioimaging National Council of ResearchNapoli 80131Italy

The high incidence of rectal cancer in both sexes makes it one of the most common tumors,with significant morbidity and mortality *** define the best treatment option and optimize patient outcome,several rectal cancer biological variables must be ***,medical imaging plays a crucial role in the characterization of this disease,and it often requires a multimodal *** resonance imaging is the first-choice imaging modality for local staging and restaging and can be used to detect high-risk prognostic *** tomography is widely adopted for the detection of distant ***,conventional imaging has recognized limitations,and many rectal cancer characteristics remain assessable only after surgery and histopathology *** is a growing interest in artificial intelligence applications in medicine,and imaging is by no means an *** introduction of radiomics,which allows the extraction of quantitative features that reflect tumor heterogeneity,allows the mining of data in medical images and paved the way for the identification of potential new imaging *** manage such a huge amount of data,the use of machine learning algorithms has been ***,without prior explicit programming,they can be employed to build prediction models to support clinical decision *** this review,current applications and future perspectives of artificial intelligence in medical imaging of rectal cancer are presented,with an imaging modality-based approach and a keen eye on unsolved *** results are promising,but the road ahead for translation in clinical practice is rather long.

关键词： Rectal cancer Radiomics Radiogenomics Artificial intelligence Machine learning Deep learning

Colonic perforation by a transmural and transvalvular migrated retained sponge:Multi-detector computed tomography findings

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World Journal of Gastroenterology 2014年第15期20卷 4457-4461页

作者： Luigi Camera Marco Sagnelli paolo Guadagno pier paolo Mainenti Teresa Marra Maria Scotto di Santolo Landino Fei Marco Salvatore Department of Radiology University "Federico Ⅱ"80131 NaplesItaly Institute of Biostructures and Bioimaging National Research Council (CNR)-Via Tommaso De Amicis 9580131 NaplesItaly Gastrointestinal Surgery Unit-Second University School 80131 NaplesItaly

Transmural migrated retained sponges usually impact at the level of the ileo-cecal valve leading to a small bowel *** passed through the ileo-cecal valve,a retained sponge can be propelled forward by peristaltic activity and eliminated with *** report the case of a 52-year-old female with a past surgical history and recurrent episodes of abdominal pain and *** physical examination,a generalized resistance was observed with tenderness in the right ***-enhanced multi-detector computed tomography findings were consistent with a perforated right colonic diverticulitis with several out-pouchings at the level of the ascending colon and evidence of free air in the right parieto-colic gutter along with an air-fluid collection within the *** addition,a ring-shaped hyperdense intraluminal material was also *** surgery,the ascending colon appeared irregularly thickened and folded with a focal wall interruption and a peri-visceral abscess at the level of the hepatic flexure,but no diverticula were found.A right hemi-colectomy was performed and on dissection of the surgical specimen a retained laparotomy sponge was found in the bowel lumen.

关键词： Retained sponge Transmural migration Multi-detector computed tomography Colonic perforation Acute abdomen

How Much Fossil Fuel Is in the Earth?

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Journal of Geoscience and Environment Protection 2019年第5期7卷 61-68页

作者： pier paolo Prosini Department of Energy Technologies ENEA Italian National Agency for New Technologies Energy and Sustainable Economic Development Santa Maria di Galeria Rome Italy

In this work, by using an indirect method based on the correspondence between the amount of oxygen in the atmosphere and the quantity of fossil fuel in the Earth, the resources of fossil fuels were evaluated to be about 1.9 × 1016 ton. Unluckily, only a small part of these fuels is easily accessible. Nevertheless, their quantity is so high that it is reasonable to assume that fossil fuels will continue to dominate the global energy scene for several years. The extensive use of fossil fuels alters the ratio between oxygen and carbon dioxide in the atmosphere. The effects of this change are however so slow that they become important only on the geological time scale.

关键词： Fossil Fuels Oxygen Production Consumption Rate Carbon Dioxide Atmosphere

Role of advanced imaging techniques in the evaluation of oncological therapies in patients with colorectal liver metastases

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World Journal of Gastroenterology 2023年第3期29卷 521-535页

作者： Martina Caruso Arnaldo Stanzione Anna Prinster Laura Micol Pizzuti Arturo Brunetti Simone Maurea pier paolo Mainenti Department of Advanced Biomedical Sciences University of Naples"Federico II"Napoli 80131Italy Institute of Biostructures and Bioimaging National Research CouncilNapoli 80131Italy

In patients with colorectal liver metastasis(CRLMs)unsuitable for surgery,oncological treatments,such as chemotherapy and targeted agents,can be ***-sectional imaging[computed tomography(CT),magnetic resonance imaging(MRI),18-fluorodexoyglucose positron emission tomography with CT/MRI]evaluates the response of CRLMs to therapy,using post-treatment lesion shrinkage as a qualitative imaging *** point is critical because the risk of toxicity induced by oncological treatments is not always balanced by an effective response to ***,there is a pressing need to define biomarkers that can predict treatment responses and estimate the likelihood of drug resistance in individual *** quantitative imaging(diffusionweighted imaging,perfusion imaging,molecular imaging)allows the in vivo evaluation of specific biological tissue features described as quantitative ***,radiomics can represent large amounts of numerical and statistical information buried inside cross-sectional images as quantitative *** a result,parametric analysis(PA)translates the numerical data contained in the voxels of each image into quantitative parameters representative of peculiar neoplastic features such as perfusion,structural heterogeneity,cellularity,oxygenation,and glucose *** could be a potentially useful imaging marker for predicting CRLMs treatment *** review describes the role of PA applied to cross-sectional imaging in predicting the response to oncological therapies in patients with CRLMs.

关键词： Colorectal cancer metastases Prediction response Computed tomography Magnetic resonance imaging Positron emission tomography Parametric imaging