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Epidemiology,therapy and outcome of hepatocellular carcinoma between 2010 and 2019 in Piedmont,Italy

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World Journal of Gastrointestinal Oncology 2024年第3期16卷 761-772页

作者： Christian Bracco Marta Gallarate Marco Badinella Martini Corrado Magnino salvatore D'Agnano Roberta Canta Giulia Racca Remo Melchio Cristina Serraino Valentina Polla Mattiot giovanni Gollè Luigi Fenoglio Department of Internal Medicine Santa Croce e Carle General HospitalCuneo 12100Italy Department of Medical Sciences "City of Health and Science"University HospitalTorino 10100Italy

BACKGROUND Hepatocellular carcinoma(HCC)is the most common primary liver malignancy and the second leading cause of cancer deaths *** is often diagnosed at an advanced stage and therefore its prognosis remains poor with a low 5-year survival *** patients have increasingly complex and constantly changing characteristics,thus up-to-date and comprehensive data are *** To analyze the epidemiology and main clinical characteristics of HCC patients in a referral center hospital in the northwest of Italy between 2010 and *** In this retrospective study,we analyzed the clinical data of all consecutive patients with a new diagnosis of HCC recorded at"Santa Croce e Carle"Hospital in Cuneo(Italy)between 1 January 2010 and 31 December *** highlight possible changes in HCC patterns over the 10-year period,we split the population into two 5-year groups,according to the diagnosis period(2010-2014 and 2015-2019).RESULTS Of the 328 HCC patients who were included(M/F 255/73;mean age 68.9±11.3 years),154 in the first period,and 174 in the *** C virus infection was the most common HCC risk factor(41%,135 patients).The alcoholic etiology rate was 18%,the hepatitis B virus infection etiology was 5%,and the non-viral/non-alcoholic etiology rate was 22%.The Child-Pugh score distribution of the patients was:class A 75%,class B 21%and class C 4%.The average Mayo end-stage liver disease score was 10.6±3.7.A total of 55 patients(17%)were affected by portal vein thrombosis and 158(48%)by portal *** average nodule size of the HCC was 4.6±3.1 cm.A total of 204 patients(63%)had more than one nodule<3,and 92%(305 patients)had a non-metastatic stage of the *** Barcelona Clinic Liver Cancer(BCLC)staging distribution of all patients was:4%very early,32%early,23%intermediate,34%advanced,and 7%*** survival rate was 1.6±0.3 *** 20%of the patients underwent ***,presence of ascites,BCLC stage and therapy w

关键词： Hepatocellular carcinoma Hepatitis virus Alcoholic hepatitis Non-alcoholic fatty liver disease Diagnosis Etiology Treatment

Frequency of and reasons behind non-listing in adult patients referred for liver transplantation: Results from a retrospective study

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World Journal of Transplantation 2024年第2期14卷 99-106页

作者： Marco Biolato Luca Miele Giuseppe Marrone Claudia Tarli Antonio Liguori Rosaria Calia giovanni Addolorato salvatore Agnes Antonio Gasbarrini Maurizio Pompili Antonio Grieco Department of Medical and Surgical Sciences CEMADFondazione Policlinico Universitario Agostino Gemelli IRCCSRome 00168Italy Department of Translational Medicine and Surgery Catholic University of Sacred HeartRome 00168Italy

BACKGROUND Few studies have evaluated the frequency of and the reasons behind the refusal of listing liver transplantation *** To assess the ineligibility rate for liver transplantation and its *** A single-center retrospective study was conducted on adult patients which entailed a formal multidisciplinary assessment for liver transplantation *** predictors for listing were evaluated using multivariable logistic *** In our center,314 patients underwent multidisciplinary work-up before liver transplantation enlisting over a three-year *** most frequent reasons for transplant evaluation were decompensated cirrhosis(51.6%)and hepatocellular carcinoma(35.7%).The non-listing rate was 53.8%and the transplant rate was 34.4%for the whole *** hundred and five motivations for ineligibility were *** most common contraindications were psychological(9.3%),cardiovascular(6.8%),and surgical(5.9%).Inappropriate or premature referral accounted for 76(37.1%)*** multivariable analysis,a referral from another hospital(OR:2.113;95%CI:1.259–3.548)served as an independent predictor of *** A non-listing decision occurred in half of our cohort and was based on an inappropriate or premature referral in one case out of *** referral from another hospital was taken as a strong predictor of non-listing.

关键词： Controindication Eligibility Evaluation Referral Personalized medicine

Clinical applications of hepatocyte transplantation

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World Journal of Gastroenterology 2009年第17期15卷 2074-2077页

作者： Giada Pietrosi giovanni Battista Vizzini salvatore Gruttadauria Bruno Gridelli Department of Gastroenterology and Hepatology Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IsMeTT) University of Pittsburgh Medical Center Palermo 90127 Italy Department of Surgery Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IsMeTT) University of Pittsburgh Medical Center Palermo 90127 Italy

The shortage of organ donors is a problem worldwide, with approximately 15% of adult patients with lifethreatening liver diseases dying while on the waiting list. The use of cell transplantation for liver disease is an attempt to correct metabolic defects, or to support liver function as a bridge to liver transplantation and, as such, has raised a number of expectations. Most of the available studies briefly reported here focus on adult hepatocyte transplantation (HT), and the results are neither reproducible nor comparable, because the means of infusion, amount of injected cells and clinical variability differ among the studies. To better understand the specif ic role of HT in the management of end-stage liver disease, it is important that controlled studies, designed on the principles of evidence-based medicine, be done in order to guarantee the reproducibility of results.

关键词： Hepatocyte transplantation Metabolic dis-eases Chronic liver disease Liver failure Stem cells

Capsule endoscopy in pediatrics: A 10-years journey

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World Journal of Gastroenterology 2014年第44期20卷 16603-16608页

作者： salvatore Oliva Stanley A Cohen giovanni Di Nardo Gianfranco Gualdi salvatore Cucchiara Emanuele Casciani Department of Pediatrics Pediatric Gastroenterology Unit Sapienza University of Rome Children’s Center for Digestive Health Care Radiology DEA Sapienza University of Rome University Hospital Umberto I

Video capsule endoscopy (CE) for evaluation the esophagus (ECE), small bowel (SBCE) and the colon (CCE) is particularly useful in pediatrics, because this imaging modality does not require ionizing radiation, deep sedation or general anesthesia. The risk of capsule retention appears to be dependent on indication rather than age and parallels the adult experience by indication, making SBCE a relatively safe procedure with a significant diagnostic yield. The newest indication, assessment of mucosal change, greatly enhances and expands its potential benefit. The diagnostic role of CE extends beyond the SB. The use of ECE also may enhance our knowledge of esophageal disease and assist patient care. Colon CCE is a novel minimally invasive and painless endoscopic technique allowing exploration of the colon without need for sedation, rectal intubation and gas insufflation. The limited data on ECE and CCE in pediatrics does not yet allow the same conclusions regarding efficacy; however, both appear to provide safe methods to assess and monitor mucosal change in their respective areas with little discomfort. Moreover, although experience has been limited, the patency capsule may help lessen the potential of capsule retention; and newly researched protocols for bowel cleaning may further enhance CE’s diagnostic yield. However, further research is needed to optimize the use of the various CE procedures in pediatric populations.

关键词： Capsule endoscopy Children Small bowel Pediatric endoscopy

A pediatric non-protein losing Menetrier's disease successfully treated with octreotide long acting release

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World Journal of Gastroenterology 2012年第21期18卷 2727-2729页

作者： giovanni Di Nardo salvatore Oliva Marina Aloi Federica Ferrari Simone Frediani Adriana Marcheggiano salvatore Cucchiara Department of Pediatrics Pediatric Gastroenterology and Liver Unit Sapienza University of Rome00161 Rome Italy Department of Medical Science Sapienza University of Rome00161 Rome Italy

Pediatric Menetrier's disease (MD) is an uncommon, acute, self-limited hypertrophic gastropathy characterized by enlarged gastric folds associated with epithelial hyperplasia and usually accompanied by protein losing gastropathy. Gastric cytomegalovirus infection is found in one third of MD children and its treatment is often associated with remission. Diagnosis often requires fullthickness biopsy due to inability to detect typical histological findings with conventional endoscopic biopsy. We report an uncommon case of non self-limited pediatric MD needing endoscopic mucosal resection for diagnosis which was then successfully treated with octreotide long-acting release (LAR). To the best of our knowledge, this is the first pediatric MD case successfully treated with octreotide LAR. Our experience suggests octreotide LAR as treatment for refractory MD before gastrectomy.

关键词： Menetrier’s disease Octreotide Endoscopic mucosal resection Children

Evaluation of the potential exposure of butterflies to genetically modified maize pollen in protected areas in Italy

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Insect Science 2018年第4期25卷 549-561页

作者： salvatore Arpaia Ferdinando Baldacchino Sara Bosi giovanni Burgio Simona Errico Rosaria Alessandra Magarelli Antonio Masetti salvatore Santorsola ENEA-Italian National Agency for New Technologies Energy and Sustainable Economic Development Research Centre Trisaia Rotondella (MT) Italy Dipartimento di Scienze Agrarie Alma Mater Studiorum Universita di Bologna Bologna Italy

Environmental impacts of genetically modified crops are mandatorily assessed during their premarket phase. One of the areas of concern is the possible impact on nontar- get organisms. Crops expressing Cry toxins might affect Lepidoptera larvae living outside cultivated fields, through pollen deposition on wild plants, which constitute their food source. While pollen toxicity varies among different events, possible exposure ofnontarget species depends on the agro-environmental conditions. This study was conducted in two protected areas in Italy, characterized by different climatic conditions, where many Lepi- doptera species thrive in proximity to maize cultivations. To estimate the possible exposure in absence of the actual stressor （e.g., Cryl-expressing maize plants）, we conducted a two-year field survey of butterflies and weeds. Indicator species were selected--Aglais （Inachis） io in the Northern site and Vanessa cardui in the Southern site--and their phe- nology was investigated. Pollen dispersal from maize fields was measured by collection in Petri dishes. Duration and frequency of exposure was defined by the overlap between pollen emission and presence of larvae on host plants. Different risk scenarios are expected in the two regions： highest exposure is foreseen forA. io in the Northern site, while minimal exposure is estimated for V. cardui in the Southern site. In the latter case, locally grown maize cultivars flower in mid-summer in coincidence with an aestivation period for several butterfly species due to hot and dry conditions. Moreover, host plants of V. cardui are at the end of their life cycle thus limiting food availability.

关键词： environmental risk assessment exposure assessment genetically modified plants Lepidoptera nontarget organisms receiving environment

Colorectal cancer and 18FDG-PET/CT:What about adding the T to the N parameter in loco-regional staging?

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World Journal of Gastroenterology 2011年第11期17卷 1427-1433页

作者： Pier Paolo Mainenti Delfina Iodice Sabrina Segreto giovanni Storto Mario Magliulo giovanni Domenico De Palma Marco salvatore Leonardo Pace Istituto di Biostrutture e Bioimmagini Consiglio Nazionale delle Ricerche Naples 80131Italy Department of Biomorphological and Functional Sciences University of Naples"Federico II"Naples 80131Italy Istitituto di Ricovero e Cura a carattere scientifico Centro di Riferimento Oncologico della BasilicataRionero in Vulture 85028 PZItaly Department of General Surgery Geriatry and EndoscopyUniversity of Naples"Federico II"Naples 80131Italy

AIM:To evaluate whether FDG-positron emission tomography(PET)/computed tomography(CT)may be an accurate technique in the assessment of the T stage in patients with colorectal ***:Thirty four consecutive patients(20 men and 14 women;mean age:63 years)with a histologically proven diagnosis of colorectal adenocarcinoma and scheduled for surgery in our hospital were enrolled in this *** patients underwent FDG-PET/CT *** primary tumor site and extent were evaluated on PET/CT *** wall invasion was analysed according to a modified T classification that considers only three stages(≤T2,T3,T4).Assessment of accuracy was carried out using 95%confidence intervals for ***:Thirty five/37(94.6%)adenocarcinomas were identified and correctly located on PET/CT ***/CT correctly staged the T of 33/35 lesions identified showing an accuracy of 94.3%(95%CI:87%-100%).All T1,T3 and T4 lesions were correctly staged,while two T2 neoplasms were overstated as ***:Our data suggest that FDG-PET/CT may be an accurate modality for identifying primary tumor and defining its local extent in patients with colorectal cancer.

关键词： Cancer Colorectal Positron emission tomography/computed tomography Staging

Pseudopneumoperitoneum in chronic intestinal pseudo-obstruction:A case report

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World Journal of Gastroenterology 2011年第24期17卷 2972-2975页

作者： Luigi Camera Milena Calabrese giovanni Sarnelli Margaret Longobardi Alba Rocco Rosario Cuomo Marco salvatore Department of Bio-morphological and Functional Sciences University "Federico II" Institute of Bioimages and Biostructures National Research Council Department of Clinical and Experimental Medicine Gastroenterology UnitUniversity "Federico II"

Chronic intestinal pseudo-obstruction(CIPO) is a rare disease due to a severe gastrointestinal motility disorder which may mimic,on both clinical and radiological grounds,mechanical *** report a case of a 26-year-old woman who presented to our institution for plain abdominal radiography for referred long-lasting constipation with recurrent episodes of abdominal pain and *** X-ray,performed both in the upright and supine position,an isolated air-fluid level was depicted in the left flank,together with a number of radiological signs suggestive of ***,subphrenic radiolucency could be observed in the upright ***,the intestinal wall of some jejunal loops appeared to be outlined in the right ***,the inferior cardiac border was clearly depicted in the upright *** patient however had no evidence ofperitoneal signs but only hypoactive bowel *** multi-detector computed tomography(MDCT) of the abdomen and pelvis was therefore *** revealed abnormal air-driven distension of the small and large bowel,without evidence of extraluminal *** radiological signs of pneumoperitoneum turned out to be false-positive *** patient was submitted to pan-colonoscopy and to anorectal manometry to rule out Hirshprung's disease,and was finally discharged with a diagnosis of CIPO.

关键词： Pseudopneumoperitoneum Abdominal radi-ography Multi-detector computed tomography Motilitydisorders Chronic intestinal pseudo-obstruction

Effect of perioperative blood transfusion on clinical outcomes in hepatic surgery for cancer

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World Journal of Gastroenterology 2009年第32期15卷 3976-3983页

作者： Gianlorenzo Dionigi Luigi Boni Francesca Rovera Stefano Rausei salvatore Cuffari giovanni Cantone Alessandro Bacuzzi Renzo Dionigi Department of Surgical Sciences Azienda Ospedaliera-Polo UniversitarioUniversity of InsubriaVia Guicciardini21100 VareseItaly Department of Anesthesiology Azienda Ospedaliera-Polo Universitario21100 VareseItaly

Allogeneic blood transfusion during liver resection for malignancies has been associated with an increased incidence of different types of complications: infectious complications, tumor recurrence, decreased survival. Even if there is clear evidence of transfusion-induced immunosuppression, it is difficult to demonstrate that transfusion is the only determinant factor that decisively affects the outcome. In any case there are several motivations to reduce the practice of blood transfusion. The advantages and drawbacks of different transfusion alternatives are reviewed here, emphasizing that surgeons and anesthetists who practice in centers with a high volume of liver resections, should be familiar with all the possible alternatives.

关键词： Blood transfusion Blood products Allogeneicblood transfusion Intraoperative autotransfusion Preoperative autologous blood donation Intraoperativeisovolemic hemodilution Infectious complications Liverresection Hepatocellular carcinoma