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Hepatobiliary Surgery and Nutrition 2024年第4期13卷 699-702页

作者： Massimo Primignani Giulia Tosetti Andrea Artoni Fondazione irccs Ca’Granda ospedale maggiore Policlinico–SC Gastroenterologia ed Epatologia MilanItaly Angelo Bianchi Bonomi Hemophilia and Thrombosis Center Fondazione IRCCS Ca'Granda Ospedale Maggiore PoliclinicoMilanItaly

Portal hypertension caused by non-cirrhotic(and non neoplastic)splanchnic vein thrombosis(NC-SVT)is responsible for 5–10%of portal hypertension cases in the western world(1).Chronic myeloproliferative neoplasms(MPN)or systemic prothrombotic disorders are in cause in about 40%of subjects,while in about 30%a local condition,such as recent abdominal surgery or infection/inflammation triggers the *** local condition,however,can only be the precipitating cause,since a thorough screening allows identifying the co-occurrence of systemic thrombophilia in about 30%of such ***,screening is mandatory even in cases where the cause of NC-SVT seems ***,about 30%of cases of NC-SVT remains unexplained and defined idiopathic(1).

关键词： Non-cirrhotic splanchnic vein thrombosis factor VIII thrombosis recurrence

Beyond dentistry:could prevention and screening for neurodegenerative diseases start in the dental office?

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Neural Regeneration Research 2024年第1期19卷 156-157页

作者： Francesca R.Buccellato Daniela Galimberti Gianluca M.Tartaglia Department of Biomedical Surgical and Dental SciencesUniversity of MilanMilanItalyFondazione IRCCS Ca’GrandaOspedale Maggiore PoliclinicoMilanItaly

The differential diagnosis of neurodegenerative diseases is complex and relies on clinical assessment,biomarker levels in cerebrospinal fluid,neuroimaging and neuropsychological *** efforts of the scientific community are focused on two aspects:a)the discovery of minimally invasive biomarkers;b)the discovery of early biomarkers that can predict the progression to clinical disease in the presymptomatic stage of a *** the impact of the number of patients affected by chronic neurodegenerative diseases on public health expenditures,early diagnosis seems to be a primary need of our society.

关键词： diagnosis diseases prevention

Colon and rectal cancer:An emergent public health problem

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World Journal of Gastroenterology 2024年第7期30卷 644-651页

作者： Marina Pinheiro David Nascimento Moreira Michele Ghidini LAQV REQUIMTEDepartment of ChemistryFaculty of PharmacyUniversity of Porto4050-313 PortoPortugal Unidade de Saúde Pública Unidade Local de Saúde Barcelos/EsposendeBarcelinhos 4755-069BragaPortugal Medical Oncology Unit Fondazione IRCCS Ca’Granda Ospedale Maggiore PoliclinicoMilan 20122Italy

Colorectal cancer ranks third globally,with a high mortality *** the United States,and different countries in Europe,organized population screenings exist and include people between 50 and 74 years of *** screenings have allowed an early diagnosis and consequently an improvement in health *** and rectal cancer(CRC)is a disease of particular interest due to the high global burden associated with it and the role attributed to prevention and early diagnosis in reducing morbidity and *** study is a review of CRC pathology and includes the most recent scientific evidence regarding this pathology,as well as a diagnosis of the epidemiological situation of ***,the recommendation from a public health perspective will be discussed in detail taking into account the context and the most current recommendations.

关键词： Colon and rectal neoplasia Colon and rectal tumor Mortality Morbidity

Inflammation as a cause of acute myocardial infarction in patients with myeloproliferative neoplasm

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World Journal of Cardiology 2024年第2期16卷 58-63页

作者： Amedeo Tirandi Elisa Schiavetta Elia Maioli Fabrizio Montecucco Luca Liberale Department of Internal Medicine University of GenoaGenoa 16132Italy irccs ospedale Policlinico San Martino Genoa–Italian Cardiovascular NetworkGenoa 16132Italy

Myeloproliferative neoplasms(MPN)are a group of diseases characterized by the clonal proliferation of hematopoietic progenitor or stem *** are clinically classifiable into four main diseases:chronic myeloid leukemia,essential thrombocythemia,polycythemia vera,and primary *** pathologies are closely related to cardio-and cerebrovascular diseases due to the increased risk of arterial thrombosis,the most common underlying cause of acute myocardial *** evidence shows that the classical Virchow triad(hypercoagulability,blood stasis,endothelial injury)might offer an explanation for such ***,patients with MPN might have a higher number and more reactive circulating platelets and leukocytes,a tendency toward blood stasis because of a high number of circulating red blood cells,endothelial injury or overactivation as a consequence of sustained inflammation caused by the neoplastic clonal *** abnormal cancer cells,especially when associated with the JAK2V617F mutation,tend to proliferate and secrete several inflammatory *** sustains a pro-inflammatory state throughout the *** direct consequence is the induction of a pro-thrombotic state that acts as a determinant in favoring both venous and arterial thrombus ***,MPN patients need to be carefully evaluated to be treated not only with cytoreductive treatments but also with cardiovascular protective strategies.

关键词： Inflammation Myeloproliferative neoplasm Acute coronary syndrome Myocardial infarction Thrombosis Cancer

Ultrasound unveiling:Decoding venous congestion in heart failure for precision management of fluid status

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World Journal of Cardiology 2024年第6期16卷 306-309页

作者： Davide Ramoni Federico Carbone Fabrizio Montecucco Department of Internal Medicine University of GenoaGenoa 16132Italy Department of Internal Medicine IRCCS Ospedale Policlinico San MartinoGenoa 16132Italy

This editorial discusses the manuscript by Di Maria et al,published in the recent issue of the World Journal of *** here focus on the still elusive pathophysiological mechanisms underlying cardio-renal syndrome(CRS),despite its high prevalence and the substantial worsening of both kidney function and heart *** the measure of right atrial pressure through right cardiac catheterization remains the most accurate albeit invasive and costly procedure,integrating bedside ultrasound into diagnostic protocols may substantially enhance the staging of venous congestion and guide therapeutic *** particular,with the assessment of Doppler patterns across multiple venous districts,the Venous Excess Ultrasound(VExUS)score improves the management of fluid overload and provides insight into the underlying factors contributing to cardio-renal *** specific echocardiographic parameters,particularly those concerning the right heart,may thus improve the VExUS score sensitivity,offering perspective into the nuanced comprehension of cardio-renal dynamics.A multidisciplinary approach that consistently incorporates the use of ultrasound is emerging as a promising advance in the understanding and management of CRS.

关键词： Cardio-renal syndrome Fluid overload Heart failure Ultrasound assessment Venous congestion Venous excess ultrasound score

Facing ethical concerns in the age of precise gene therapy:Outlook on inherited arrhythmias

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World Journal of Cardiology 2024年第2期16卷 64-66页

作者： Federico Carbone Fabrizio Montecucco Department of Internal Medicine University of GenoaGenoa 16132Italy irccs ospedale Policlinico San Martino Genoa Italian Cardiovascular NetworkGenoa 16132Italy

This editorial,comments on the article by Spartalis et al published in the recent issue of the World Journal of *** here provide an outlook on potential ethical concerns related to the future application of gene therapy in the field of inherited *** monogenic diseases with no or few therapeutic options available through standard care,inherited arrhythmias are ideal candidates to gene therapy in their *** with inherited arrhythmias typically have a poor quality of life,especially young people engaged in agonistic *** genome editing for treatment of inherited arrhythmias still has theoretical application,advances in CRISPR/Cas9 technology now allows the generation of knock-in animal models of the ***,clinical translation is somehow expected soon and this make consistent discussing about ethical concerns related to gene editing in inherited *** off-target activity is a known technical issue,but its relationship with ethnical and individual genetical diversity raises concerns about an equitable ***,the costeffectiveness may further limit an equal distribution of gene *** economic burden of gene therapies on healthcare systems is is increasingly recognized as a pressing concern.A growing body of studies are reporting uncertainty in payback periods with intuitive short-term effects for insurance-based healthcare systems,but potential concerns for universal healthcare systems in the long term as ***,those aspects strongly indicate a need of regulatory entities to manage those issues.

关键词： Ethics Inherited arrhythmias CRISPR/Cas9 Gene therapy Equitable accessibility

Nrf2 and Her3 co-expression in cholangiocarcinoma:Possible biological pathways for potential therapeutic approach

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Hepatobiliary & Pancreatic Diseases International 2024年第3期23卷 317-321页

作者： Paola Parente Valentina Angerilli Giuseppe Zamboni Angelo Sparaneo Fabiola Fiordelisi Leonarda Di Candia Matteo Fassan Paolo Graziano Pathology Unit Fondazione IRCCS Casa Sollievo della Sofferenza71013San Giovanni Rotondo(Foggia)Italy Department of Medicine(DIMED) Surgical Pathology UnitUniversity of Padua35128Padua(Padua)Italy Pathology Unit IRCCS Ospedale Sacro Cuore Don Calabria37024Negrar(Verona)Italy Laboratory of Oncology Fondazione IRCCS Casa Sollievo della Sofferenza71013San Giovanni Rotondo(Foggia)Italy Veneto Institute of Oncology IOV-irccs 35124Padua(Padua)Italy

To the Editor:Cholangiocarcinomas(CCAs)are heterogeneous group of malignancies,encompassing intrahepatic CCA(iCCA),and extrahepatic CCA(eCCA);they are also classified into common hepatic duct cholangiocarcinoma(CHDCCA),choledocus extrapancreatic cholangiocarcinoma(EPCCA)and choledocus intrapancreatic cholangiocarcinoma(IPCCA)and,finally,gallbladder carcinoma(GBCCA).CCAs are relatively uncommon but.

关键词： carcinoma gallbladder Nrf2

Sex differences in the risk of retinopathy of prematurity:a systematic review,frequentist and Bayesian meta‑analysis,and meta‑regression

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World Journal of Pediatrics 2024年第4期20卷 340-352页

作者： Tamara M.Hundscheid Silvia Gulden Mohamad F.Almutairi František Bartoš Giacomo Cavallaro Eduardo Villamor Division of Neonatology Department of PediatricsMosaKids Children’s HospitalMaastricht University Medical Center(MUMC+)School for Oncology and Reproduction(GROW)Maastricht UniversityP.Debyelaan 25.P.O.Box 58006202 AZ MaastrichtThe Netherlands Neonatal Intensive Care Unit Sant’Anna HospitalComoItaly Department of Psychology University of Amsterdam1001 NK AmsterdamThe Netherlands Neonatal Intensive Care Unit Fondazione IRCCS Ca’Granda Ospedale Maggiore PoliclinicoMilanItaly

Background Retinopathy of prematurity(ROP)is generally considered to be more frequent in males than in ***,it is not known whether sex differences in ROP affect all degrees of the condition,are global and have changed as neonatology has *** aimed to conduct a systematic review and meta-analysis of studies addressing sex differences in the risk of developing *** PubMed/MEDLINE and Embase databases were *** frequentist,random-effects risk ratio(RR)and 95%confidence interval(CI)were *** model averaged(BMA)meta-analysis was used to calculate the Bayes factors(BFs).The BF10 is the ratio of the probability of the data under the alternative hypothesis(H1)over the probability of the data under the null hypothesis(H0).Results We included 205 studies(867,252 infants).Frequentist meta-analysis showed a positive association between male sex and severe ROP(113 studies,RR=1.14,95%CI=1.07–1.22)but no association with any ROP(144 studies,RR=1.00,95%CI=0.96–1.03).BMA showed extreme evidence in favor of H1 for severe ROP(BF10=71,174)and strong evidence in favor of H0 for any ROP(BF10=0.05).The association between male sex and severe ROP remained stable over time and was present only in cohorts from countries with a high or high-middle sociodemographic *** Our study confirms the presence of a male disadvantage in severe ROP but not in less severe forms of the *** are variations in the sex differences in ROP,depending on geographical location and sociodemographic level of the countries.

关键词： Oxidative stress Retinopathy of prematurity Sex characteristics

Advancing immunosuppression in liver transplantation: A narrative review

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Hepatobiliary & Pancreatic Diseases International 2024年第5期23卷 441-448页

作者： Samuele Iesari Francesca Laura Nava Ilaria Elena Zais Laurent Coubeau Mariano Ferraresso Evaldo Favi Jan Lerut General Surgery and Kidney Transplantation Fondazione IRCCS Ca’Granda Ospedale Maggiore Policlinico15 Via della Commenda20122 MilanItaly Institut de Recherche Expérimentale et Clinique Universitécatholique de Louvain10 Avenue Hippocrate1200 BrusselsBelgium Service de Chirurgie et Transplantation Abdominale Cliniques Universitaires Saint-Luc55 Avenue Hippocrate1200 BrusselsBelgium Department of Clinical Sciences and Community Health Universitàdegli Studi di Milano19 Via della Commenda20122 MilanItaly

Immunosuppression is essential to ensure recipient and graft survivals after liver transplantation(LT). However, our understanding and management of the immune system remain suboptimal. Current immunosuppressive therapy cannot selectively inhibit the graft-specific immune response and entails a significant risk of serious side effects, i.e., among others, de novo cancers, infections, cardiovascular events, renal failure, metabolic syndrome, and late graft fibrosis, with progressive loss of graft function. Pharmacological research, aimed to develop alternative immunosuppressive agents in LT, is behind other solidorgan transplantation subspecialties, and, therefore, the development of new compounds and strategies should get priority in LT. The research trajectories cover mechanisms to induce T-cell exhaustion, to inhibit co-stimulation, to mitigate non-antigen-specific inflammatory response, and, lastly, to minimize the development and action of donor-specific antibodies. Moreover, while cellular modulation techniques are complex, active research is underway to foster the action of T-regulatory cells, to induce tolerogenic dendritic cells, and to promote the function of B-regulatory cells. We herein discuss current lines of research in clinical immunosuppression, particularly focusing on possible applications in the LT setting.

关键词： Liver transplantation Immunosuppression Drug development Long-term results Clinical operational tolerance

A Comparison of Airborne Formaldehyde Field Measurements Collected in an Anatomic Pathology Laboratory

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Journal of Environmental Protection 2024年第8期15卷 827-841页

作者： Maria Teresa Piccardo Massimo Cipolla Alberto Izzotti Paola Canepa Vincenzo Fontana Mutagenesis& Cancer Prevention Unit IRCCS Ospedale Policlinico San Martino Genova Italy Department of Experimental Medicine (DIMES) University of Genova Genova Italy Clinical Epidemiology Unit IRCCS Ospedale Policlinico San Martino Genova Italy

Environmental monitoring of airborne formaldehyde (FA) using sensitive methodologies is fundamental to prevent health risks. The objective of this study was to compare three different FA monitoring methods during the daily activities of an anatomic pathology laboratory. Daily eight-hour measurements deriving from Radiello® passive diffusive samplers (PDS), NEMo XT continuous optical sensor (COS), and multi-gas 1512 photoacoustic monitor (MPM) were simultaneously compared over a period of 14 working days. Given the different daily distributions of the measurements performed by the three devices, all measurements were time-aligned for comparison purposes. The 95% limit of agreement (LOA) method was applied to estimate the degree of concordance of each device with respect to the others. Formaldehyde arithmetic mean measured using PDS was 32.6 ± 10.4 ppb (range: 19.8 - 62.7). The simultaneous measures performed by COS and MPM were respectively 42.4 ± 44.8 ppb (range: 7.0 - 175.0) and 189.0 ± 163.7 ppb (range: 40.0 - 2895.4). The MPM geometric mean (171.3 ppb) was approximately five times higher than those derived from COS (32.3 ppb) and PDS (31.4 ppb). The results of the LOA method applied to log-transformed FA data showed the same systematic discrepancies between MPM and the other two devices. A good agreement between PDS and COS could lead to a tailored approach according to the individual specificity of these techniques. This tool may be useful for accurately assessing the risk of FA exposure among healthcare workers. However, the limited specificity of the MPM does not support its use as a monitoring method for FA in the workplace.

关键词： Occupational Exposure Occupational Health Formaldehyde Monitoring Devices Indoor Air Quality