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Relief of jaundice in malignant biliary obstruction:When should we consider endoscopic ultrasonography-guided hepaticogastrostomy as an option?

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Hepatobiliary & Pancreatic Diseases International 2022年第3期21卷 234-240页

作者： Alessandro Fugazza Matteo Colombo Marco Spadaccini Edoardo Vespa Roberto Gabbiadini Antonio Capogreco Alessandro Repici Andrea Anderloni Division of Gastroenterology and Digestive Endoscopy Humanitas Research Hospital-IRCCSMilanItaly Department of Biomedical Sciences Humanitas UniversityMilanItaly

Background:Since it was first described in 2001,endoscopic ultrasonography-guided biliary drainage(EUS-BD)has emerged as an alternative procedure for achieving an endoscopic internal drainage in case of endoscopic retrograde cholangiopancreatography(ERCP)*** drainage can be achieved by either a transduodenal extrahepatic approach through EUS-guided choledochoduodenostomy(EUS-CDS),or a transgastric intrahepatic approach,namely EUS-guided hepaticogastrostomy(EUS-HGS)which already holds a remarkable place in the treatment of patients with malignant biliary *** sources:For this review we did a comprehensive search of PubMed/MEDLINE from inception to May 31,2021 for papers with a significant sample size(at least 20 patients enrolled)dealing with *** on technical success,clinical success and rate of adverse events were ***:A total of 22 studies with different design,com prising 874 patients,were *** success was achieved in about 96% of cases(ranging from 65% to 100%).Clinical success was obtained in almost 91% of cases(ranging from 76% to 100%).Overall rate of adverse events was 19%(ranging from 0% to 35%).Abdominal pain,self-limiting pneumoperitoneum,bile leak,cholangitis,bleeding,perforation and intraperitoneal migration of the stent were the most ***:Despite both safety and efficacy profile,at the moment HGS still remains a challenging procedure at every single step and must therefore be conducted by a very experienced endoscopist in interventional EUS and ERCP procedures,who is able to deal with the possible severe adverse events of this procedure.A rapid introduction in clinical practice of dedicated devices is desiderable.

关键词： EUS-guided hepaticogastrostomy EUS-guided biliary drainage Hepaticogastrostomy Interventional EUS

Nilotinib:from animal-based studies to clinical investigation in Alzheimer's disease patients

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Neural Regeneration Research 2023年第4期18卷 803-804页

作者： Annalisa Nobili Marcello D’Amelio Maria Teresa Viscomi Department of Medicine and Surgery University Campus Bio-MedicoDepartment of Experimental NeuroscienceIRCCS Santa Lucia FoundationRomeItaly Department of Life Science and Public Health Section of Histology and Embryology UniversitàCattolica del Sacro CuoreFondazione Policlinico Universitario“A.Gemelli”IRCCSRomeItaly

Since their first description in the brains of patients suffering from Alzheimer ’s disease(AD), more than 100 years ago, extracellular amyloid-β(Aβ) plaques and intracellular neurofibrillary tangles have been the principal focus of AD research. However, this focus has led to the failure of several long and promising clinical trials, and the efficacy of new Aβ-targeting drugs to slow down the disease progression is still controversial despite being successful in reducing the Aβ load.

关键词： Alzheimer Aβ drugs

Intra-abdominal myositis ossificans-a clinically challenging disease:A case report

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World Journal of Orthopedics 2023年第5期14卷 362-368页

作者： Gabriele Carbone Valentina Andreasi Paola De Nardi Department of Gastrointestinal Surgery IRCCS San Raffaele HospitalMilan 20132Italy

BACKGROUND Myositis ossificans(MO)is an uncommon disorder characterized by heterotopic ossification within soft *** a few cases of intra-abdominal MO(IMO)have been described in the *** could be difficult to understand and a wrong diagnosis could lead to an improper *** SUMMARY We herein report the case of IMO in a healthy 69-year-old *** patient presented with an abdominal mass in the left lower quadrant.A computed tomography scan showed an inhomogeneous mass with multiple *** patient underwent radical excision of the *** findings were compatible with *** months later the patient showed a recurrence causing hemorrhagic shock due to intractable intralesional *** patients eventually died within three months since *** The case described could be classified as post-traumatic MO that developed close to the previously fractured iliac *** subsequent surgical procedure was ineffective and the disease rapidly *** misleading intraoperative diagnosis led to improper surgical treatment with a dramatic evolution.

关键词： Myositis ossificans Post-traumatic Diagnosis Surgical treatment Prognosis Case report

Modified mesenchymal stem cells in cancer therapy: A smart weapon requiring upgrades for wider clinical applications

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World Journal of Stem Cells 2022年第1期14卷 54-75页

作者： Carla Vicinanza Elisabetta Lombardi Francesco Da Ros Miriam Marangon Cristina Durante Mario Mazzucato Francesco Agostini Stem Cell Unit Centro di Riferimento Oncologico di AvianoIRCCSAviano 33081Italy

Mesenchymal stem stromal cells(MSC)are characterized by the intriguing capacity to home toward cancer cells after systemic ***,MSC can be harnessed as targeted delivery vehicles of cytotoxic agents against *** cancer patients,MSC based advanced cellular therapies were shown to be safe but their clinical efficacy was ***,the amount of systemically infused MSC actually homing to human cancer masses is insufficient to reduce tumor ***,induction of an unequivocal anticancer cytotoxic phenotype in expanded MSC is necessary to achieve significant therapeutic *** vivo cell modifications are,thus,required to improve anti-cancer properties of *** based cellular therapy products must be handled in compliance with good manufacturing practice(GMP)*** the present review we include MSCimproving manipulation approaches that,even though actually tested at preclinical level,could be compatible with GMP *** particular,we describe possible approaches to improve MSC homing on cancer,including genetic engineering,membrane modification and cytokine ***,we discuss appropriate modalities aimed at inducing a marked cytotoxic phenotype in expanded MSC by direct chemotherapeutic drug loading or by genetic *** conclusion,we suggest that,to configure MSC as a powerful weapon against cancer,combinations of clinical grade compatible modification protocols that are currently selected,should be introduced in the final *** standardized cancer clinical trials are required to test the efficacy of ameliorated MSC based cell therapies.

关键词： Cancer Mesenchymal stem stromal cells Good manufacturing practice Homing Targeted therapy Ex vivo cell modification

Viral hepatitis:Innovations and expectations

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World Journal of Gastroenterology 2022年第5期28卷 517-531页

作者： Simona Leoni Alberto Casabianca Benedetta Biagioni Ilaria Serio Division of Internal Medicine Hepatobiliary and Immunoallergic DiseasesIRCCS Azienda Ospedaliero-Universitaria di BolognaBologna 40138Italy

Viral hepatitis is a significant health problem worldwide,associated with morbidity and *** B,C,D,and occasionally E viruses(HBV,HCV,HDV,and HEV)can evolve in chronic infections,whereas hepatitis A virus(HAV)frequently produces acute self-limiting *** the last years,different studies have been performed to introduce new antiviral *** most important goal in the treatment of viral hepatitis is to avoid chronic liver disease and *** review analyzes currently available therapies,in particular for viruses associated with chronic liver *** focus is especially on HBV and HCV therapies,investigating new drugs already introduced in clinical practice and clinical *** also describe new entry inhibitors,developed for the treatment of chronic HDV and HBV and currently available treatments for *** last drugs introduced have shown important efficacy in HCV,with achievable target HCV elimination by ***,renewed interest in curative HBV therapies has been registered;current nucleotide/nucleoside analogs positively impact liver-related complications,ensuring high safety and *** approaches to HBV cure are based on new antivirals,targeting different steps of the HBV life cycle and immune *** improved knowledge of the HDV life cycle has facilitated the development of some direct-acting agents,as bulevirtide,the first drug conditionally approved in Europe for HDV associated compensated liver *** studies are required to identify a new therapeutic approach in hepatitis E,especially in immunosuppressed patients.

关键词： Viral hepatitis Chronic liver disease Treatments Antiviral Immunotherapy Vaccination

Current guidelines for the management of celiac disease:A systematic review with comparative analysis

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World Journal of Gastroenterology 2022年第1期28卷 154-175页

作者： Alberto Raiteri Alessandro Granito Alice Giamperoli Teresa Catenaro Giulia Negrini Francesco Tovoli Division of Internal Medicine Hepatobiliary and Immunoallergic DiseasesIRCCS Azienda Ospedaliero-Universitaria di BolognaBologna 40138Italy

BACKGROUND Wheat and other gluten-containing grains are widely consumed,providing approximately 50%of the caloric intake in both industrialised and developing *** widespread diffusion of gluten-containing diets has rapidly led to a sharp increase in celiac disease *** condition was thought to be very rare outside Europe and relatively ignored by health professionals and the global ***,in recent years,the discovery of important diagnostic and pathogenic milestones has led to the emergence of celiac disease(CD)from obscurity to global *** modifications have prompted experts worldwide to identify effective strategies for the diagnosis and follow-up of *** scientific societies,mainly from Europe and America,have proposed guidelines based on CD's most recent *** To identify the most recent scientific guidelines on CD,aiming to find and critically analyse the main *** We performed a database search on PubMed selecting papers published between January 2010 and January 2021 in the English *** was lastly accessed on 1 March *** We distinguished guidelines from 7 different scientific societies whose reputation is worldwide recognized and representative of the clinical practice in different geographical *** were noted in the possibility of a no-biopsy diagnosis,HLA testing,follow-up protocols,and *** We found a relatively high concordance between the guidelines for *** modifications have occurred in the last years,especially about the possibility of a no-biopsy diagnosis in *** modifications are expected in the next future and will probably involve the extension of the non-invasive diagnosis to the adult population and the follow-up modalities.

关键词： Celiac disease Gluten Gluten-free diet Gluten sensitivity Clinical guidelines Non-invasive diagnosis Histopathological findings Serological markers Genetics

Low ADAMTS-13/VWF ratio and altered gut–liver axis predict complications of advanced chronic liver disease:a pilot study

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Gastroenterology Report 2022年第1期10卷 671-673页

作者： Francesca Romana Ponziani Monica Sacco Maira Tardugno Francesco Santopaolo Adriana Marsico Stefano Manna Stefano Lancellotti Antonio Gasbarrini Raimondo De Cristofaro Maurizio Pompili Internal Medicine and Gastroenterology–Hepatology Unit Fondazione Policlinico Universitario Agostino Gemelli IRCCSRomeItaly Translational Medicine and Surgery Department Catholic UniversityRomeItaly Hemorrhagic and Thrombotic Diseases Service Fondazione Policlinico Universitario Agostino Gemelli IRCCSRomeItaly

Introduction Liver cirrhosis is characterized by a delicate balance between thrombosis and *** extinction due to microvascular thrombosis is involved in disease progression and anticoagulant therapy with low-molecular-weight heparin has been shown to reduce the frequency of hepatic decompensation[1].Dysbiosis and bacterial translocation,which are hallmarks of liver cirrhosis,can influence the coagulation system through inflammation or by the activation of Toll-like receptors on endothelial cells and platelets[2].However,little is known about the connections between the coagulation system,the occurrence of liver cirrhosis complications,and the gut microbiome.

关键词： complications inflammation bleeding

To resect or not to resect?-the dilemma in oligometastatic breast cancer

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Hepatobiliary Surgery and Nutrition 2022年第4期11卷 623-625页

作者： Sara Lonardi Valentina Guarneri Medical Oncology 3 Istituto Oncologico Veneto IOV-IRCCSPaduaItaly Department of Surgery Oncology and GastroenterologyUniversity of PaduaPaduaItaly Medical Oncology 2 Istituto Oncologico Veneto IOV-IRCCSPaduaItaly

Despite the good prognosis of the vast majority of breast cancer cases,about 10%is firstly diagnosed with stage IV,while 20-30%of localized disease treated with curative intent will eventually relapse(1).Hepatic metastases are the third site of relapse,after lymph-nodes and bone,but,due to the early systemic nature of breast cancer,rarely the recurrence is liver-limited.

关键词： breast cancer prognosis

Current role of surgery for tuberous sclerosis complex-associated epilepsy

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Pediatric Investigation 2022年第1期6卷 16-22页

作者： Nicola Specchio Giusy Carfi Pavia Luca de Palma Alessandro De Benedictis Chiara Pepi Marta Conti Carlo Efisio Marras Federico Vigevano Paolo Curatolo Rare and Complex Epilepsy Unit Department of NeurosciencesBambino GesùChildren’s HospitalIRCCSRomeItaly Neurosurgery Unit Department of NeurosciencesBambino GesùChildren’s HospitalIRCCSRomeItaly Department of Neurosciences Bambino GesùChildren’s HospitalIRCCSRomeItaly Child Neurology and Psychiatry Unit Systems Medicine DepartmentTor Vergata UniversityRomeItaly

Tuberous sclerosis complex(TSC)is a rare multisystem,autosomal dominant neurocutaneous syndrome in which epilepsy is the most common of several neurological and psychiatric *** two thirds of patients develop drug-resistant epilepsy for whom surgical resection of epileptogenic foci is indicated when seizures remain inadequately controlled following trial of two antiseizure *** challenge with presurgical and surgical approaches with patients with TSC is overcoming the complexity from the number of tubers and the multiplex epileptogenic network forming the epileptogenic *** suggest that seizure freedom is achieved by 55%-60%of patients,but predictive factors for success have remained elusive,which makes for unconfident selection of surgical *** article presents three different cases as illustrations of the potential challenges faced when assessing the suitability of TSC patients for epilepsy surgery.

关键词： Epilepsy Everolimus Imaging Prognostics Surgery Tuberous sclerosis complex(TSC)