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Non-anatomical liver resection for hepatocellular carcinoma:the SegSubTe classification to overcome the problem of heterogeneity

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Hepatobiliary & Pancreatic Diseases International 2024年第3期23卷 265-271页

作者： Mattia Garancini Alessandro Fogliati Mauro Alessandro Scotti Cristina Ciulli Francesca Carissimi Antonio Rovere Luca Gianotti Fabrizio Romano Unit of Hepatobiliopancreatic Surgery Department of SurgeryASST-MonzaSan Gerardo HospitalUniversity of Milano-Bicoccavia Pergolesi 33MonzaMB 20052Italy Interventional Radiology Department of RadiologyASST-MonzaSan Gerardo HospitalMilano-Bicocca Universityvia Pergolesi 33MonzaMB 20052Italy

Background:The superiority of anatomical resection(AR)***-anatomical resection(NAR)in the surgical management of hepatocellular carcinoma(HCC)is *** are well-defined procedures,whereas the lack of NAR standardization results in heterogeneous *** study aimed to introduce the SegSubTe classification for NAR detailing the appropriateness of the level of surgical section of the Glissonean pedicles feeding the ***:A single-center retrospective analysis of pre-and postoperative imaging of consecutive patients treated with NAR for single HCC between 2012 and 2020 was *** quality of surgery was assessed classifying the type of vascular supply and the level of surgical section(segmental,subsegmental or terminal next to the tumor)of vascular pedicles feeding the HCCs;then,the population was divided in“SegSubTe-IN”or“SegSubTe-OUT”groups,and the tumor recurrence and survival were ***:Ninety-seven patients who underwent NAR were included;76%were SegSubTe-IN and 24%were *** disease recurrence,local recurrence and cut-edge recurrence in the SegSubTe-IN ***-OUT groups were 50%vs.83%(P=0.006),20%vs.52%(P=0.003)and 16%vs.39%(P=0.020),***-OUT odds ratio for local recurrence was 4.1 at univariate regression ***-,three-,and five-year disease-free survival rates in the SegSubTe-IN ***-OUT groups were 81%,58%and 35%vs.46%,21%and 11%,respectively(P<0.001).Conclusions:The SegSubTe classification is a useful tool to stratify and standardize NAR for HCC,aiming at improving long-term oncological outcomes and reducing the heterogeneity of quality of NAR for HCC.

关键词： Hepatocellular carcinoma Intraoperative ultrasound Liver surgery Computed tomography Surgical procedure

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Hemiarthroplasty for irreparable distal radius fractures in the elderly:A comprehensive review

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World Journal of Orthopedics 2024年第6期15卷 578-584页

作者： Adriano Cannella Ludovico Caruso Giulia Maria Sassara Giuseppe Taccardo Marco Passiatore Marina Marescalchi Rocco De Vitis Department of Orthopaedics Fondazione Policlinico Universitario A Gemelli IRCCSRome 00168Italy Department of Bone and Joint Surgery ASST-Spedali CiviliBrescia 25123Italy

BACKGROUND Elderly patients maintaining functional independence can now be candidates for primary wrist hemiarthroplasty to manage acute irreparable distal radius fractures(DRFs).However,further investigation with long-term follow-up is required to validate these initial *** To review the literature on the outcomes of distal radius hemiarthroplasty with available implants to assess its viability as a treatment *** A comprehensive review of the literature was conducted using electronic databases,including PubMed,Medline,and *** search terms employed were"distal radius fracture","hemiarthroplasty","wrist arthroplasty",and related *** search was restricted to articles published in English from 1980 until June *** criteria encompassed cases or case series of DRF treated with hemiarthroplasty,providing clinical or radiographic outcomes,and published in peer-reviewed *** A total of 2508 articles from PubMed and 883 from Scopus were identified *** screening and removal of duplicates,13 articles met the inclusion *** articles,predominantly clinical retrospective studies,provided insights into hemiarthroplasty outcomes,including functional improvements and *** was a treatment option for complex DRF,particularly those cases with severe comminution,intraarticular involvement,or severe *** outcomes demonstrated improvements in pain relief,wrist mobility,and grip strength,with variability across *** included implant loosening,infection,nerve injury,and stiffness,with varying incidence rates influenced by surgical techniques and implant ***-term outcomes were inadequately documented,warranting further *** Hemiarthroplasty is a promising treatment for irreparable DRF in the ***-term outcomes and complications require further study.

关键词： Irreparable distal radius fracture Hemiarthroplasty Osteoporosis Wrist prosthesis Elderly

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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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Dual mobility in primary total hip arthroplasty:A temptation from the devil or a blessing from above

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World Journal of Orthopedics 2024年第6期15卷 512-519页

作者： Raymond Klumpp Linda Boerci Francesco Buonanotte Marco Zeppieri Unita Operativa Complessa Ortopedia e Traumatologia Ospedale Treviglio-Caravaggio ASSTBergamo Ovest 24047Italy Department of Orthopedics Universitàdegli Studi di Milano-BicoccaMonza 20090Italy Department of Ophthalmology University Hospital of UdineUdine 33100Italy

Dual mobility(DM)bearings have gained significant attention in the field of total hip arthroplasty(THA)as a valid treatment option in cases of revision for instability after THA whereas its use in primary THA is still a matter of *** manuscript explores the pathology,incidence,diagnosis,treatment options,prognosis,ongoing studies in the literature,and future perspectives related to the use of DM bearings employed in primary *** bearings are primarily designed to address one of the major concerns in THA:Instability of the prosthetic *** is both for the surgeon and the patient a devastating postoperative complication,leading to significant pain and subsequent apprehension by the patient and may require revision *** use of DM implants poses the worry of wear-related complications,such as accelerated polyethylene wear and osteolysis,which also pose challenges to long-term implant *** technique has seen a steady rise in recent years,with multiple studies reporting favorable *** incidence of their utilization varies among institutions and surgeons,reflecting differing preferences and patient *** diagnosis of instability and wear-related complications in THA often involves clinical assessment,imaging modalities such as X-rays,computed tomography scans,and sometimes advanced imaging techniques like magnetic resonance *** bearings can be considered as an option when patients present neurologic pathologies such as Parkinson's disease or recurrent dislocations after *** bearings provide an additional articulation point within the implant,facilitating a greater range of motion and inherent *** design allows for reduced risk of dislocation and improved functional *** implant manufacturers offer different designs and sizes of DM bearings to suit individual patient *** literature suggests that the use of DM bearings in primary THA has demonstrated promising outcomes in terms

关键词： Dual mobility First implant Hip arthroplasty Surgical technique Differential diagnosis

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Long-term assessment of collagenase treatment for Dupuytren’s contracture:A 10-year follow-up study

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World Journal of Orthopedics 2024年第4期15卷 355-362页

作者： Marco Passiatore Vitale Cilli Adriano Cannella Ludovico Caruso Giulia Maria Sassara Giuseppe Taccardo Rocco De Vitis Department of Bone and Joint Surgery ASST-Spedali CiviliBrescia 25123Italy Department of Chirurgie de la Main Centre Hospitalier Interregional Edith CavellBruxelles 1160Belgium Department of Orthopedics Fondazione Policlinico Universitario Agostino Gemelli IRCSSRome 00168Italy

BACKGROUND Enzymatic fasciotomy with collagenase clostridium histolyticum(CCH)has revolutionized the treatment for Dupuytren’s contracture(DC).Despite its benefits,the long-term outcomes remain *** study presented a comprehensive 10-year follow-up assessment of the enduring effects of CCH on patients with *** To compare the short-term(12 wk)and long-term(10 years)outcomes on CCH treatment in patients with *** A cohort of 45 patients was treated with CCH at the metacarpophalangeal(MCP)joint and the proximal interphalangeal(PIP)joint and underwent systematic *** study adhered to multicenter trial protocols,and assessments were conducted at 12 wk,7 years,and 10 years *** Thirty-seven patients completed the 10-year *** 10 years,patients treated at the PIP joint exhibited a 100%***,patients treated at the MCP joint only showed a 50%*** satisfaction varied,with a lower satisfaction reported in PIP joint *** exceeding 20 degrees on the total passive extension deficit was observed,indicating a challenge for sustained *** differences were noted between outcomes at the 7-year and 10-year *** CCH demonstrated sustained efficacy when applied to the MCP ***,caution is warranted for CCH treatment at the PIP joint due to a high level of recurrence and low patient ***-intervention is needed within a decade of treatment.

关键词： Collagenase Xiapex Dupuytren disease Dupuytren recurrence Long term follow-up

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Surgical management of tegmen defects of the temporal bone and meningoencephalic herniation: our experience

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Journal of Otology 2024年第1期19卷 30-34页

作者： Giuseppe De Donato Emanuela Fuccillo Alberto Maria Saibene Elena Ferrari Giorgia Carlotta Pipolo Antonia Pisani Liliana Colletti Anastasia Urbanelli Luigi De Donato Giovanni Felisati Otorhinolaryngology Unit Head and Neck DepartmentASST Santi Paolo e Carlo HospitalVia Antonio di Rudinì820142MilanItaly Department of Health Sciences University of MilanVia Festa del Perdono720122MilanItaly Department of Biomedical Surgical and Dental SciencesUniversity of MilanVia Festa del Perdono720122MilanItaly ENT Unit Department of Surgical SciencesUniversity of TurinVia Verdi810124TurinItaly

1. Introduction The tegmental wall of the tympanic cavity is a thin plate of the temporal bone that separates the middle cranial fossa(MCF) from the ear. This anatomical region consists of two areas: an anterior one, comprised of the tegmen tympani(To′th et al., 2007), and a posterior one, formed by the tegmen antri and the tegmen mastoideum(Makki et al., 2011). In some patients, the tegmental region of the temporal bone can be interrupted, causing a tegmen defect(TD). A TD is sometimes associated with a meningoencephalic herniation(MEH), in which brain tissue herniates through a TD.

关键词： al. herniation bone

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Cold ischemia time in liver transplantation:An overview

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World Journal of Hepatology 2024年第6期16卷 883-890页

作者： Manuela Cesaretti Alessandro Izzo Roberta Anna Pellegrino Alessandro Galli Orestes Mavrothalassitis Department of HPB and Liver Transplantation Brotzu HospitalCagliari 09122Italy Department of Nanophysic Istituto Italiano di TecnologiaGenova 16163Italy Department of Critical Care Medicine and Anesthesia ASST Papa Giovanni XXIIIBergamo 24100Italy Department of Anesthesia and Perioperative Care University of California San FranciscoSan FranciscoCA 94143United States

The standard approach to organ preservation in liver transplantation is by static cold storage and the time between the cross-clamping of a graft in a donor and its reperfusion in the recipient is defined as cold ischemia time(CIT).This simple definition reveals a multifactorial time frame that depends on donor hepatectomy time,transit time,and recipient surgery time,and is one of the most important donor-related risk factors which may influence the graft and recipient’s ***,the growing demand for the use of marginal liver grafts has prompted scientific exploration to analyze ischemia time factors and develop different organ preservation *** review details the CIT definition and analyzes its different *** also explores the most recent strategies developed to implement each timestamp of CIT and to protect the graft from ischemic injury.

关键词： Cold ischemia time Liver transplantation Organ donation Donation after cardiac death Warm ischemia time Machine perfusion

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Applications of endoscopic ultrasound elastography in pancreatic diseases: From literature to real life

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World Journal of Gastroenterology 2022年第9期28卷 909-917页

作者： Clara Benedetta Conti Giacomo Mulinacci Raffaele Salerno Marco Emilio Dinelli Roberto Grassia Interventional Endoscopy Unit ASST MonzaOspedale San GerardoMonza 20900Italy Gastroenterology and Endoscopy Unit ASST Fatebenefratelli-SaccoMilan 20121Italy Gastroenterology and Endoscopy Unit ASST CremonaCremona 26100Italy

Elastography is a non-invasive method widely used to measure the stiffness of the tissues,and it is available in most endoscopic ultrasound machines,using either qualitative or quantitative *** ultrasound elastography is a tool that should be applied to obtain a complementary evaluation of pancreatic diseases,together with other imaging tests and clinical *** can be informative,especially when studying pancreatic masses and help the clinician in the differential diagnosis between benign or malignant ***,further studies are necessary to standardize the method,increase the reproducibility and establish definitive cut-offs to distinguish between benign and malignant pancreatic ***,even if promising,elastography still provides little information in the evaluation of benign conditions.

关键词： Elastography Pancreas Pancreatic stiffness Pancreatitis Pancreatic cancer Endosonography Endoscopic ultrasound Quantitative elastography Strain elastography Pancreatic diseases

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Gallbladder biliary lithotripsy:A new rationale applied to old treatment

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World Journal of Gastroenterology 2022年第7期28卷 763-765页

作者： Lorenzo Dioscoridi Massimiliano Mutignani Digestive Endoscopy Unit ASST NiguardaMilan 20100Italy

Pure endoscopic treatment of combined cholelithiasis and choledocholithiasis is possible due to the chance to use together both endoscopic retrograde cholangiopancreatography(ERCP)and endoscopic ultrasound(EUS)*** endotherapy permits to treat biliary stones in the main bile duct by standard ERCP and gallbladder stones by EUS-guided cholecystoduodenostomy eventually associated to intracorporeal lithotripsy to achieve optimal results.

关键词： Endoscopic ultrasound-guided gallbladder drainage Biliary lithotripsy Gallstone lithotripsy Gallbladder biliary lithotripsy New rationale

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Unusual Presentation of COVID-19: Encephalitis and Syndrome of Inappropriate Anti-Diuretic Hormone Secretion

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International Journal of Clinical Medicine 2020年第10期11卷 559-564页

作者： Maresca Andrea Mongiardi Christian Montalbetti Lorenzo Dentali Francesco Ageno Walter Mauri Marco Baj Andreina Grandi Anna Maria Grossi Paolo Dalla Gasperina Daniela Zerba Francesco Sessa Aurelio Guasti Luigina University of Insubria Varese Italy asst-settelaghi Varese Italy

COVID-19 is a new challenge in clinical medicine. Although typical presentations include fever and pneumonia, we describe a case of COVID-19 presenting with neurological symptoms of encephalitis and infectious-related syndrome of inappropriate anti-diuretic hormone secretion. Because of the epidemic health problems, it is crucial to identify these patients as early as possible to follow the isolation procedures. We suggest that unclear neurological clinical presentations of patients should be considered for COVID-19.

关键词： COVID-19 SARS-Cov-2 Encephalitis Syndrome of Inappropriate Anti-Diuretic Hormone Isolation Procedures

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