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Preoperative and postoperative risk factors for periprosthetic joint infection in primary total hip arthroplasty:A 1-year experience

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World Journal of Orthopedics 2022年第10期13卷 903-910页

作者： Giuseppe Ferdinando Tella Cesare Donadono Francesco Castagnini Barbara Bordini Monica Cosentino Michele Di Liddo Francesco Traina Ortopedia-Traumatologia e Chirurgia protesica e dei reimpianti d'anca e di ginocchio IRCCS Istituto Ortopedico RizzoliBologna 40125Italy Laboratorio di Tecnologia Medica IRCCS Istituto Ortopedico RizzoliBologna 40125Italy

BACKGROUND Periprosthetic joint infection(PJI)in primary total hip replacement(THR)is one of the most important threats in orthopedic surgery,so one important surgeon’s target is to avoid or early diagnose a *** the incidence of PJI is very low(0.69%)in our department,with an average follow-up of 595 d,this infection poses a serious threat due to the difficulties of treatment and the lower functional outcomes after *** To study the incidence of PJI in all operations occurring in the year 2016 in our department to look for predictive signs of potential *** We counted 583 THR for 578 patients and observed only 4 cases of infection(0.69%)with a mean follow-up of 596 d(min 30,max 1451).We reviewed all medical records to collect the data:duration and time of the surgery,presence,type and duration of the antibiotic therapy,preoperative diagnosis,blood values before and after surgery,transfusions,presence of preoperative drugs(in particularly anticoagulants and antiaggregant,corticosteroids and immunosuppressants),presence of some comorbidities(high body mass index,blood hypertension,chronic obstructive pulmonary disease,cardiac ischemia,diabetes,rheumatological conditions,previous local infections).RESULTS No preoperative,intraoperative,or postoperative analysis showed a higher incidence of *** did not find any class with evident major odds of *** our study,we did not find any border value to predict PJI and all patients had similar values in both groups(non-PJI and PJI).Only some categories,such as female patients,showed more frequency of PJI,but this difference related to sex was not statistically *** We did not find any category with a higher risk of PJI in THR,probably due to the lack of few cases of infection.

关键词： Primary total hip replacement Periprosthetic joint infection Preoperative risk factors Postoperative risk factors Preoperative and postoperative blood value Total hip arthroplasty

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The power of prevention:how tenofovir and entecavir are changing the game in hepatocellular carcinoma

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Hepatobiliary Surgery and Nutrition 2023年第6期12卷 936-940页

作者： Endrit Shahini Rossella Donghia Antonio Facciorusso Gastroenterology Unit National Institute of Gastroenterology-IRCCS“Saverio de Bellis”Castellana GrotteItaly Data Science Unit National Institute of Gastroenterology-IRCCS“Saverio de Bellis”Castellana GrotteItaly Gastroenterology Unit Department of Medical SciencesUniversity of FoggiaFoggiaItaly

Introduction Individual patient data(IPD)meta-analysis by Choi et al.(1)compared hepatocellular carcinoma(HCC)risk between the entecavir(ETV)and tenofovir(TDF)in treatment-naïve chronic hepatitis B(CHB)patients using a multivariable Cox proportional hazards model from 11 Asian studies,totaling 42,939 patients receiving nucles(t)tide analogues(NAs)for more than one year.

关键词： Hepatocellular carcinoma(HCC) liver cancer cirrhosis,hepatitis B virus(HBV)

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Impact of COVID-19 in individuals with and without pre-existent digestive disorders with a particular focus on elderly patients

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World Journal of Gastroenterology 2023年第26期29卷 4099-4119页

作者： Alfredo Papa Marcello Covino Sara Sofia De Lucia Angelo Del Gaudio Marcello Fiorani Giorgia Polito Carlo Romano Settanni Andrea Piccioni Francesco Franceschi Antonio Gasbarrini CEMAD Center for Diagnosis and Treatment of Digestive DiseasesFondazione Policlinico Universitario A.GemelliIRCCSRoma 00168Italy CEMAD UniversitàCattolica del Sacro CuoreRoma 00168Italy Department of Emergency UniversitàCattolica del Sacro Cuore-Fondazione Policlinico Universitario A.GemelliIRCCSRome 00168Italy Emergency Medicine UniversitàCattolica del Sacro CuoreRoma 00168Italy Digestive Disease Center Fondazione Policlinico Universitario A.Gemelli IRCCS-UniversitàCattolica del Sacro CuoreRome 00168Italy Department of Emergency Fondazione Policlinico Universitario A.GemelliIRCCSRoma 00168Italy Department of Emergency UniversitàCattolica del Sacro CuoreRoma 00168Italy

Coronavirus disease 2019(COVID-19)has several extrapulmonary ***(GI)symptoms are among the most frequent clinical manifestations of COVID-19,with severe consequences reported in elderly ***,the impact of COVID-19 on patients with pre-existing digestive diseases still needs to be fully elucidated,particularly in the older *** review aimed to investigate the impact of COVID-19 on the GI tract,liver,and pancreas in individuals with and without previous digestive diseases,with a particular focus on the elderly,highlighting the distinctive characteristics observed in this ***,the effectiveness and adverse events of the anti-COVID-19 vaccination in patients with digestive disorders and the peculiarities found in the elderly are discussed.

关键词： COVID-19 Elderly Inflammatory bowel disease Liver disease Cirrhosis Pancreatic disease

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Endoluminal vacuum-assisted therapy to treat rectal anastomotic leakage:A critical analysis

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World Journal of Gastroenterology 2022年第14期28卷 1394-1404页

作者： Andrea Vignali Paola De Nardi Department of Gastrointestinal Surgery IRCCS San Raffaele Scientific InstituteMilano 20132Italy Department of Surgery Vita-Salute UniversityMilano 20132Italy

Endoluminal vacuum-assisted therapy(EVT)has been introduced recently to treat colorectal anastomotic leaks in clinically stable non-peritonitic *** application has been mainly reserved to low colorectal and colo-anal *** main advantage of this new procedure is to ensure continuous drainage of the abscess cavity,to promote and to accelerate the formation of granulation tissue resulting in a reduction of the abscess *** reported results are promising allowing a higher preservation of the anastomosis when compared to conventional treatments that include trans-anastomotic tube placement,percutaneous drainage,endoscopic clipping of the anastomotic defect or stent ***,despite this procedure is gaining acceptance among the surgical community,indications,inclusion criteria and definitions of success are not yet standardized and extremely heterogeneous,making it difficult to reach definitive conclusions and to ascertain which are the real benefits of this new ***,long-term and functional results are poorly *** present review is focused on critically analyzing the theoretical benefits and risks of the procedure,short-and long-term functional results and future direction in the application of EVT.

关键词： Anastomotic leakage Rectal surgery Endoluminal vacuum therapy Endosponge Complications

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Concomitant medications and circulating tumor cells:friends or foes?

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Cancer Drug Resistance 2023年第1期6卷 30-34页

作者： Serena Di Cosimo Vera Cappelletti Department of Advanced Diagnostics Fondazione IRCCS Istituto Nazionale dei TumoriMilano 20133Italy

The use of concomitant medications by patients with cancer is observed almost globally;however,little attention has been paid to this topic in the medical *** clinical studies do not describe the type and duration of drugs used at the time of inclusion and during treatment or how these drugs may affect the experimental and/or standard *** less information has been published on the potential interaction between concomitant medications and tumor ***,we do know that concomitant drugs can complicate cancer clinical trials and biomarker development,thus contributing to their interaction,leading to side effects,and resulting in suboptimal adherence to anticancer *** the basis of these premises and moving from the study by Jurisova et al.,which reported the effect of commonly used drugs on the prognosis of women with breast cancer and the detection of circulating tumor cells(CTCs),we comment on the role of CTCs as an emerging diagnostic and prognostic tool for breast *** also report the known and hypothesized mechanisms of CTC interplay with other tumor and blood components,possibly modulated by widespread drugs,including over-the-counter compounds,and discuss the possible implications of commonly used concomitant medications on CTC detection and *** considering all these points,it is conceivable that concomitant drugs are not necessarily a problem,but on the contrary,their virtuous mechanisms can be exploited to reduce tumor spread and enhance the effect of anticancer therapies.

关键词： Breast cancer concomitant medications circulating tumor cells

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Any role for transarterial radioembolization in unresectable intrahepatic cholangiocarcinoma in the era of advanced systemic therapies?

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World Journal of Hepatology 2023年第12期15卷 1284-1293页

作者： Alessandra Elvevi Alice Laffusa Federica Elisei Sabrina Morzenti Luca Guerra Antonio Rovere Pietro Invernizzi Sara Massironi Division of Gastroenterology and Center for Autoimmune Liver Diseases Department of Medicine and SurgeryUniversity of Milano-Bicocca and European Reference Network on Hepatological Diseases(ERN RARELIVER)Fondazione IRCCS San Gerardo dei Tintori HospitalMonza 20900Italy Department of Nuclear Medicine Fondazione IRCCS San Gerardo dei Tintori University of Milano BicoccaMonza 20900Italy Medical Physics Fondazione IRCCS San Gerardo dei TintoriMonza 20900Italy Department of Radiology and Interventional Radiology Fondazione IRCCS San Gerardo dei Tintori HospitalMonza 20900Italy

Intrahepatic cholangiocarcinoma(iCCA)is recognized as the second most frequently diagnosed liver malignancy,following closely after hepatocellular *** incidence has seen a global upsurge in the past several ***,due to the lack of well-defined risk factors and limited diagnostic tools,iCCA is often diagnosed at an advanced stage,resulting in a poor *** surgery is the only potentially curative option,it is rarely ***,there are ongoing investigations into various treatment approaches for unresectable iCCA,including conventional chemotherapies,targeted therapies,immunotherapies,and locoregional *** study aims to explore the role of transarterial radioembolization(TARE)in the treatment of unresectable iCCA and provide a comprehensive *** findings suggest that TARE is a safe and effective treatment option for unresectable iCCA,with a median overall survival(OS)of 14.9 months in the study *** on TARE for unresectable iCCA,both as a first-line treatment(as a neo-adjuvant down-staging strategy)and as adjuvant therapy,have reported varying median response rates(ranging from 34%to 86%)and median OS(12-16 mo).These differences can be attributed to the heterogeneity of the patient population and the limited number of participants in the *** studies have identified tumor burden,portal vein involvement,and the patient’s performance status as key prognostic ***,a phase 2 trial evaluated the combination of TARE and chemotherapy(cisplatin-gemcitabine)as a first-line therapy for locally advanced unresectable *** results showed promising outcomes,including a median OS of 22 mo and a 22%achievement in down-staging the *** conclusion,TARE represents a viable treatment option for unresectable iCCA,and its combination with systemic chemotherapy has shown promising ***,it is important to consider treatment-independent factors that can influence ***

关键词： Intrahepatic cholangiocarcinoma Transarterial radioembolization Locoregional treatment Overall Survival Response rates Neo-adjuvant therapy Combined Therapies Prognostic factors

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Improving performance of robotic liver resections with high technical complexity by Robo-Lap approach

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Hepatobiliary Surgery and Nutrition 2023年第6期12卷 981-986页

作者： Francesca Ratti Rebecca Marino Luca Aldrighetti Hepatobiliary Surgery Division IRCCS Ospedale San RaffaeleMilanItaly Vita-Salute San Raffaele University MilanItaly

Introduction The hybrid robotic-laparoscopic technique has been described-in the field of hepatic surgery-in order to overcome procedural challenges related to the lack of the robotic ultrasonic dissector(1-4):Robo-Lap approach hence combines the use of the robotic platform(specifically robotic bipolar forceps for coagulation and scissors)with the laparoscopic dissector handled by the surgeon at the table.

关键词： robotic handle approach

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Salivary biomarkers: novel noninvasive tools to diagnose chronic inflammation

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International Journal of Oral Science 2023年第2期15卷 229-240页

作者： Paola Dongiovanni Marica Meroni Sara Casati Riccardo Goldoni Douglas Vieira Thomaz Nermin Seda Kehr Daniela Galimberti Massimo Del Fabbro Gianluca MTartaglia Medicine and Metabolic Diseases Fondazione IRCCS CàGranda Ospedale Maggiore Policlinico Department of Biomedical Surgical and Dental SciencesUniversity of Milan Department of Electronics Information and Bioengineering(DEIB) Istituto di Elettronica e di Ingegneria dell'Informazione e delle Telecomunicazioni CNR Laboratory of Medicinal Pharmaceutical Chemistry Faculty of PharmacyFederal University of Goiás Department of Chemistry ?zmir Institute of TechnologyGülbah?e Kampüsü Neurology-Neurodegenerative Diseases Fondazione IRCCS CàGrandaOspedale Maggiore Policlinico UOC Maxillo-Facial Surgery and Dentistry Fondazione irccs CàGranda Ospedale Maggiore Policlinico

Several chronic disorders including type 2 diabetes(T2D),obesity,heart disease and cancer are preceded by a state of chronic lowgrade *** for the early assessment of chronic disorders encompass acute phase proteins(APP),cytokines and chemokines,pro-inflammatory enzymes,lipids and oxidative stress *** substances enter saliva through the blood flow and,in some cases。

关键词： inflammation acute chronic

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Significance of ipsilateral breast tumor recurrence after breast conserving treatment: role of surgical removal

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Chinese Journal of Cancer Research 2013年第1期25卷 22-31页

作者： Romano Demicheli Ilaria Ardoino Federico Ambrogi Roberto Agresti Elia Biganzoli Scientific Directorate IRCCS National Cancer Institute Medical Statistics and Biometry University of Milan Breast Surgery IRCCS National Cancer Institute Medical Statistics and Biometry IRCCS National Cancer Institute

Objective： To analyze the pattern over time （dynamics） of further recurrence and death after ipsilateral breast tumor recurrence （IBTR） in breast cancer patients undergoing breast conserving treatment （BCT）. Methods： A total of 338 evaluable patients experiencing IBTR were extracted from a database of 3,293 patients undergoing BCT. The hazard rates for recurrence and mortality throughout 10 years of follow-up after IBTR were assessed and were compared to the analogous estimates associated to the primary treatment. Results： In a time frame with the time origin at the surgical treatment for IBTR, the hazard rate for further recurrence displays a bimodal pattern （peaks at the second and at the sixth year）. Patients receiving mastectomy for IBTR reveal recurrence and mortality dynamics similar to that of node positive （N＋） patients receiving mastectomy as primary surgery, apart from the first two-three years, when IBTR patients do worse. If the patients with time to IBTR longer than 2.5 years are considered, differences disappear. Conclusions： The recurrence and mortality dynamics following IBTR surgical removal is similar to the corresponding dynamics following primary tumor removal. In particular, patients with time to IBTR in excess of 2.5 years behave like N＋ patients following primary tumor removal. Findings may be suitably explained by assuming that the surgical manoeuvre required by IBTR treatment is able to activate a sudden growing phase for tumor foci most of which, as suggested by the systemic model of breast cancer, would have reached the clinical level according to their own dynamics.

关键词： Breast cancer IBTR recurrence dynamics effects of surgery conservative surgery tumor homeostasis

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Endoscopic ultrasound radiofrequency ablation of pancreatic insulinoma in elderly patients:Three case reports

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World Journal of Clinical Cases 2022年第19期10卷 6514-6519页

作者： Gemma Rossi Maria Chiara Petrone Gabriele Capurso Stefano Partelli Massimo Falconi Paolo Giorgio Arcidiacono Division of Pancreato-Biliary Endoscopy and Endosonography Pancreas Translational and Clinical Research CenterSan Raffaele Scientific Institute IRCCSVita-Salute San Raffaele UniversityMilano 20132Italy Department of Pancreatic Surgery Pancreas Translational and Clinical Research CenterSan Raffaele Scientific Institute IRCCSVita-Salute San Raffaele UniversityMilano 20132Italy

BACKGROUND Endoscopic ultrasound(EUS)-guided radiofrequency ablation(RFA)has recently been proposed as a local treatment for functional pancreatic neuroendocrine neoplasms in patients unfit for surgery,in order to obtain clinical syndrome *** on the safety and long-term effectiveness of this approach are scarce,and EUS-RFA procedures are not *** SUMMARY The present case series reports 3 elderly patients with a pancreatic insulinoma and comorbidities,locally treated by EUS-guided RFA with clinical success in terms of hypoglycemic *** procedures were performed during deep sedation,under EUS control with a 19 G needle,an electrode 5-mm in size at a power of 30 W and multiple RFA applications during the same session in order to treat the whole area of the *** relief of symptoms was evident in 2 patients after the first EUS-RFA,while in the third patient a second endoscopic treatment was *** 3 patients are symptom-free without need of medications after 24 mo of follow-up with imaging follow-up showing no disease recurrence.A single adverse event of intraprocedural bleeding occurred,which was successfully treated *** EUS-RFA represents an effective and safe alternative to surgery for the treatment of insulinomas in elderly patients at high surgical ***,larger multicenter studies withlonger follow-up are needed in order to better assess its safety and clinical success.

关键词： Endoscopic ultrasound Radiofrequency ablation Insulinomas Neuroendocrine neoplasms Ablative therapies Case report

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