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Major liver resections,perioperative issues and posthepatectomy liver failure:A comprehensive update for the anesthesiologist

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World Journal of Critical Care Medicine 2024年第2期13卷 49-71页

作者： Andrea de Gasperi Laura Petrò Ombretta Amici Ilenia Scaffidi pietro Molinari Caterina Barbaglio Eva Cibelli Beatrice Penzo Elena Roselli Andrea Brunetti Maxim Neganov Alessandro Giacomoni Paolo Aseni Elena Guffanti Former Head Anesthesia and Critical Care Service 2Grande Ospedale Metropolitano Niguarda ASST GOM NiguardaMilan 20163Italy AR1 Ospedale Papa Giovanni 23Bergamo 24100Italy Anesthesia and Critical Care Service 2 Grande Ospedale Metropolitano Niguarda AR2ASST GOM NiguardaMilan 20163Italy Anestesia e Terapia Intensiva Generale Istituto Clinico HumanitasRozzano 20089Italy Chirurgia Oncologica Miniinvasiva Grande Ospedale Metropolitano Niguarda ASST GOM NiguardaMilan 20163Italy Dipartimento di Medicina d’Urgenza ed Emergenza Grande Ospedale Metropolitano Niguarda ASST GOM NiguardaMilano 20163MIItaly

Significant advances in surgical techniques and relevant medium-and long-term outcomes over the past two decades have led to a substantial expansion in the indications for major liver *** support these outstanding results and to reduce perioperative complications,anesthesiologists must address and master key perioperative issues(preoperative assessment,proactive intraoperative anesthesia strategies,and implementation of the Enhanced Recovery After Surgery approach).Intensive care unit monitoring immediately following liver surgery remains a subject of active and often unresolved *** postoperative complications,posthepatectomy liver failure(PHLF)occurs in different grades of severity(A-C)and frequency(9%-30%),and it is the main cause of 90-d postoperative ***,recently redefined with pragmatic clinical criteria and perioperative scores,can be predicted,prevented,or *** review highlights:(1)The systemic consequences of surgical manipulations anesthesiologistsmust respond to or prevent,to positively impact PHLF(a proactive approach);and(2)the maximal intensivetreatment of PHLF,including artificial options,mainly based,so far,on Acute Liver Failure treatment(s),to buytime waiting for the recovery of the native liver or,when appropriate and in very selected cases,toward *** a clinical context requires a strong commitment to surgeons,anesthesiologists,and intensivists towork together,for a fruitful collaboration in a mandatory clinical continuum.

关键词： Liver resection Chronic liver disease Preoperative assessment Vascular clamping Intraoperative hemodynamic monitoring Postoperative intensive care unit Posthepatectomy liver failure Artificial liver support

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Role of endoscopy in the bariatric surgery of patients

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World Journal of Gastroenterology 2014年第24期20卷 7777-7784页

作者： Giovanni D de Palma pietro Forestieri Center of Excellence for Technical Innovation in Surgery Department of Clinical Medicine and SurgeryUniversity of Naples Federico ⅡSchool of Medicine80131 NaplesItaly department of Clinical Medicine and Surgery University of Naples Federico ⅡSchool of Medicine80131 NaplesItaly

Obesity is an increasingly serious health problem in nearly all Western countries. It represents an important risk factor for several gastrointestinal diseases, such as gastroesophageal reflux disease, erosive esophagitis, hiatal hernia, Barrett’s esophagus, esophageal adenocarcinoma, Helicobacter pylori infection, colorectal polyps and cancer, non-alcoholic fatty liver disease, cirrhosis, and hepatocellular carcinoma. Surgery is the most effective treatment to date, resulting in sustainable and significant weight loss, along with the resolution of metabolic comorbidities in up to 80% of cases. Many of these conditions can be clinically relevant and have a significant impact on patients undergoing bariatric surgery. There is evidence that the chosen procedure might be changed if specific pathological upper gastrointestinal findings, such as large hiatal hernia or Barrett’s esophagus, are detected preoperatively. The value of a routine endoscopy before bariatric surgery in asymptomatic patients (screening esophagogastroduodenoscopy) remains controversial. The common indications for endoscopy in the postoperative bariatric patient include the evaluation of symptoms, the management of complications, and the evaluation of weight loss failure. It is of critical importance for the endoscopist to be familiar with the postoperative anatomy and to work in close collaboration with bariatric surgery colleagues in order to maximize the outcome and safety of endoscopy in this setting. The purpose of this article is to review the role of the endoscopist in a multidisciplinary obesity center as it pertains to the preoperative and postoperative management of bariatric surgery patients.

关键词： Morbid obesity Obesity surgery Endoscopy Complications Endoscopic therapy

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Folate targeted coated SPIONs as efficient tool for MRI

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Nano Research 2017年第9期10卷 3212-3227页

作者： Cinzia Scialabba roberto Puleio Davide Peddis Gaspare Varvaro pietro Calandra Giovanni Cassata Luca Cicero Mariano Licciardi Gaetano Giammona department ofScienze e Tecnologie Biologiche Chimiche e Farmaceutiche (STEBICEF) University of Palermo 90123 Palermo Italy Istituto Zooprofilattico Sperimentale della Sicilia "A. Mirri" Via Gino Marinuzzi 3 90100 Palermo Italy Institute of Structure of Matter National Research Council (CNR) Via Salaria 00015 Monterotondo Scalo (RM) Italy Istituto per Io Studio dei Materiali Nanostrutturati Consiglio Nazionale delle Ricerche Via Solaria kin. 29.300 00015 Monterotondo Stazione (RM) Italy Mediterranean Center for Human Health Advanced Biotechnologies (CHAB) ATeNCenter University of Palermo 90100 Palermo Italy

The development of more sensitive diagnostic tools allowing an early-stage and highly efficient medical imaging of tumors remains a challenge. Magnetic nanoparticles seem to be the contrast agents with the highest potential, if properly constructed. Therefore, in this study, hybrid magnetic nanoarchitectures were developed using a new amphiphilic inulin-based graft copolymer (INU-LAPEG-FA) as coating material for 10-nm spinel iron oxide (magnetite, Fe3O4) superparamagnetic nanoparticles (SPION). Folic acid (FA) covalently linked to the coating copolymer in order to be exposed onto the nanoparticle surface was chosen as the targeting agent because folate receptors are upregulated in many cancer types. Physicochemical characterization and in vitro biocompatibility study was then performed on the prepared magnetic nanoparticles. The improved targeting and imaging properties of the prepared FA-SPIONs were further evaluated in nude mice using 7-Tesla magnetic resonance imaging (MRI). FA-SPIONs exhibited the ability to act as efficient contrast agents in conventional MRI, providing a potential nanoplatform not only for tumor diagnosis but also for cancer treatment, through the delivery of anticancer drug or locoregional magnetic hyperthermia.

关键词： inulin copolymer superparamagnetic spinel iron oxide nanoparticles (SPIONs) magnetic resonance imaging (MRI) folic acid (FA) cancer targeting

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Soil loss and runoff obtained with customized precipitation patterns simulated by InfiAsper

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International Soil and Water Conservation Research 2022年第3期10卷 407-413页

作者： Daniel Fonseca de Carvalho pietro Menezes Sanchez Macedo Marinaldo Ferreira Pinto Wilk Sampaio de Almeida Nivaldo Schultz department of Engineering Institute of TechnologyFederal Rural University of Rio de JaneiroSeropedicaRio de JaneiroBrazil Postgraduate Program in Agronomy-Soil Sciences Federal Rural University of Rio de JaneiroSeropedicaRio de JaneiroBrazil Agronomy department Federal Institute of EducationScience and Technology of RondoniaCampus AriquemesRO 257Km 13AriquemesRO76870-000Brazil department of Soil Science Institute of AgronomyFederal Rural University of Rio de JaneiroSeropedicaRJBrazil

Applying constant precipitation intensity,which does not occur in natural events,is one of the main limitations concerning rainfall simulators in soil erosion *** present work evaluated the InfiAsper rainfall simulator operating with a new control panel to program rainfalls with different precipitation intensities(PI).Infiltration rates and soil and water losses were evaluated in a Distrophic Acrisol(clay loam texture)with simulated rainfalls of 30 mm and duration of 40 min,considering advanced(AD),intermediate(IN),delayed(de),and inverted intermediate(II)patterns,all with PI peaks of 110 mm h^(-1),and a constant(CT)*** experimental design was in randomized blocks with five treatments(rainfall patterns)and experimental units measuring 2.5×2.5 *** simulator worked satisfactorily,applying the rainfall according to the preconfigured *** simulated rainfall with the CT and II patterns did not promote runoff nor soil *** and runoff rates varied according to the applied rainfall pattern,reaching 97.8 and 27.3 mm h^(-1)(AD),82.1 and 39.5 mm h^(-1)(IN),and 76.2 and 49.7 mm h^(-1)(de),*** loss and surface runoff totaled each 4.77 g m^(-2)and 3.9 mm(AD),6.70 g m^(-2)and 6.8 mm(IN),and 6.03 g m^(-2)and 7.0 mm(de).The InfiAsper simulator modified enables varying precipitation intensity besides obtaining satisfactory results in the field and information consistent with the expected characteristics of natural rainfall *** the intermediate and delayed rainfall patterns,soil and water losses are higher than in the advanced.

关键词： Water erosion Rainfall simulator Precipitation intensity

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Non-variceal upper gastrointestinal bleeding: Rescue treatment with a modified cyanoacrylate

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World Journal of Gastroenterology 2016年第48期22卷 10609-10616页

作者： roberto Grassia pietro Capone Elena Iiritano Katerina Vjero Fabrizio Cereatti Mario Martinotti Gabriele Rozzi Federico Buffoli Digestive Endoscopy and Gastroenterology Unit "ASST di Cremona" department of Surgery "ASST di Cremona" department of Radiology "ASST di Cremona"

AIM To evaluate the safety and efficacy of a modified cyanoacrylate [N-butyl-2-cyanoacrylate associated with methacryloxysulfolane(NBCA + MS)] to treat nonvariceal upper gastrointestinal bleeding(NV-UGIB).METHODS In our retrospective study we took into account 579 out of 1177 patients receiving endoscopic treatment for NV-UGIB admitted to our institution from 2008 to 2015; the remaining 598 patients were treated with other treatments. Initial hemostasis was not achieved in 45 of 579 patients; early rebleeding occurred in 12 of 579 patients. Thirty-three patients were treated with modified cyanoacrylate: 27 patients had duodenal, gastric or anastomotic ulcers, 3 had post-mucosectomy bleeding, 2 had Dieulafoy's lesions, and 1 had duodenal diverticular *** Of the 45 patients treated endoscopically without initialhemostasis or with early rebleeding, 33(76.7%) were treated with modified cyanoacrylate glue, 16(37.2%) underwent surgery, and 3(7.0%) were treated with selective transarterial embolization. The mean age of patients treated with NBCA + MS(23 males and 10 females) was 74.5 years. Modified cyanoacrylate was used in 24 patients during the first endoscopy and in 9 patients experiencing rebleeding. Overall, hemostasis was achieved in 26 of 33 patients(78.8%): 19 out of 24(79.2%) during the first endoscopy and in 7 out of 9(77.8%) among early rebleeders. Two patients(22.2%) not responding to cyanoacrylate treatment were treated with surgery or transarterial embolization. One patient had early rebleeding after treatment with cyanoacrylate. No late rebleeding during the follow-up or complications related to the glue injection were *** Modified cyanoacrylate solved definitively NV-UGIB after failure of conventional treatment. Some reported life-threatening adverse events with other formulations, advise to use it as last option.

关键词： Rescue treatment Glubran Non-variceal upper gastrointestinal bleeding Endoscopic treatment Cyanoacrylate

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Extravasated contrast volumetric assessment on computed tomography angiography in gastrointestinal bleeding:A useful predictor of positive angiographic findings

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World Journal of Radiology 2024年第5期16卷 115-127页

作者： Laura Maria Cacioppa Chiara Floridi Alessandra Bruno NicolòRossini Tommaso Valeri Alessandra Borgheresi Riccardo Inchingolo Francesco Cortese Giacomo Novelli Alessandro Felicioli Mario Torresi pietro Boscarato Letizia Ottaviani Andrea Giovagnoni Division of Interventional Radiology Department of Radiological SciencesUniversity Politecnica Delle MarcheAncona 60126Italy department of Clinical Special and Dental SciencesUniversity Politecnica Delle MarcheAncona 60126Italy Division of Radiology Department of Radiological SciencesUniversity Hospital"Azienda Ospedaliero Universitaria Delle Marche"Ancona 60126Italy Interventional Radiology Unit "F Miulli"Regional General HospitalAcquaviva delle Fonti 70021Italy department of Radiology IRCCS INRCAAncona 60126Italy

BACKGROUND Gastrointestinal bleeding(GIB)is a severe and potentially life-threatening condition,especially in cases of delayed *** tomography angiography(CTA)plays a pivotal role in the early identification of upper and lower GIB and in the prompt treatment of the *** To determine whether a volumetric estimation of the extravasated contrast at CTA in GIB may be a predictor of subsequent positive angiographic *** In this retrospective single-centre study,35 patients(22 men;median age 69 years;range 16-92 years)admitted to our institution for active GIB detected at CTA and further submitted to catheter angiography between January 2018 and February 2022 were ***-three(65.7%)patients underwent endoscopy before *** volumetry was evaluated in both arterial and venous phases via a semi-automated dedicated *** rate was obtained from volume change between the two phases and standardised for unit *** were divided into two groups,according to the angiographic signs and their concordance with *** Upper bleeding accounted for 42.9%and lower GIB for 57.1%.Mean haemoglobin value at the admission was 7.7 g/dL.A concordance between positive CTA and direct angiographic bleeding signs was found in 19(54.3%)*** no significant differences in terms of bleeding volume in the arterial phase(0.55 mL vs 0.33 mL,P=0.35),a statistically significant volume increase in the venous phase was identified in the group of patients with positive angiography(2.06 mL vs 0.9 mL,P=0.02).In the latter patient group,a significant increase in bleeding rate was also detected(2.18 mL/min vs 0.19 mL/min,P=0.02).CONCLUSION In GIB of any origin,extravasated contrast volumetric analysis at CTA could be a predictor of positive angiography and may help in avoiding further unnecessary procedures.

关键词： Gastrointestinal haemorrhage Computed tomography angiography Volumetric analysis Computer-assisted image interpretation Therapeutic embolization Transcatheter arterial embolization

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全球最危险城市什么样？加拉加斯的暴力、选美与街头锐舞

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环球人文地理 2024年第17期 56-65页

作者： Zoe Alexander Sánchez ZERYO Paolo pietro Roccasalva Don Perucho Zatletic anecaroline unsplash

近日，福布斯顾问（Forbes Advisor）发布了2024年最危险城市排行榜，委内瑞拉首都—加拉加斯，以满分100分的成绩居于榜首。评分主要参考五个指标：犯罪风险、个人安全风险、健康安全风险、基础设施风险和数字安全风险。

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Targeting menin: a promising therapeutic strategy for susceptible acute leukemia subtypes

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Signal Transduction and Targeted Therapy 2023年第11期8卷 5141-5142页

作者： pietro Di Fazio department of Visceral Thoracic and Vascular SurgeryPhilipps University of MarburgBaldingerstrasse35043MarburgGermany

Two recent studies published in Nature focused on the clinical efficacy of the menin inhibitor revumenib(SNDX-5613)in KMT2A(histone-lysine N-methyltransferase 2A)-rearranged or NPM1(Nucleophosmin1)-mutant acute myeloid leukemia.1,2 These studies indicate that menin inhibition and its acquired resistance to long-term exposure to revuminib are key points for future treatment,emphasizing the role of menin as a challenging and promising target for the current treatment of leukemia.

关键词： acute clinical therapeutic

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Effect of Pressure on Cesium Iodide Band Gap

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物理化学学报 2018年第2期34卷 208-212页

作者： CEDILLO Andres CORTONA pietro departamento de Quimica Universidad Autonoma Metropolitana-Iztapalapa San Rafael Atlixco 186 09340 Mexico DF Mexico Laboratoire Structures Proprietes et Modelisation des Solides CNRS UMR 8580 Universite Paris-Saclay CentraleSupelec GrandeV

The evolution of cesium iodide band gap as a function of pressure is studied in the range from 0 to 60 GPa. Within this range, two structural phase transitions occurred, and the band gap was affected by the compression pressure and structural rearrangement. The band gap estimation under pressure, as obtained by the density functional theory methods, successfully reproduced the experimental trend of the optical gap and electrical resistivity, namely, a general decreasing tendency, an early maximum, and a discontinuous peak around 40 GPa.

关键词：密度泛函理论光学科学研究工作物理学

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Synthesis and Photophysical Properties of 9,10-Disubstituted Anthracenes

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Materials Sciences and Applications 2015年第11期6卷 943-952页

作者： roberto Pizzoferrato pietro Tagliatesta Carlo Schillaci Paolo Prosposito Roberta de Angelis Dipartimento di Ingegneria Industriale Universit&agrave di Roma Tor Vergata Roma Italy Dipartimento di Ingegneria Industriale Università di Roma Tor Vergata Roma Italy Dipartimento di Scienze e Tecnologie Chimiche Universit&agrave di Roma Tor Vergata Roma Italy Dipartimento di Scienze e Tecnologie Chimiche Università di Roma Tor Vergata Roma Italy

We report the synthesis and photophysical characterization of four 9,10-disubstituted dipheny-lanthracenes with specific modifications of the model backbone which involve both the 9,10 para substituents at the phenyl rings and the substitution with carbon-carbon triple bonds. The effects of such modifications on the photoluminescence and electroluminescence properties have been investigated on the basis of the diphenylanthracene molecular characteristics and in view of application to light-emitting devices. We have found that the substitution with the carbon-carbon triple bonds at the two 9,10-phenyls noticeably alters the electronic states of the reference molecule, also introducing a certain degree of sensitivity to the phenyl substituents, which improves the tunability of the optical emission. Differently, the 9,10 para substituents produce minor changes in the single-molecule properties, due to the lack of electronic conjugation across the 9,10-phenyls. However, even a single nitro substituent in the phenyl para position produces the formation of excimers, which appreciably reduces the optical quantum efficiency. These properties are maintained in solid-state blends and simple spin-coated bilayer electroluminescent devices have been fabricated.

关键词： Blue Material Electroluminescence PVK 9 10-Diphenylanthracene Organic Light-Emitting devices

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