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Role of Helicobacter pylori infection and the risk of cholelithiasis

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World Journal of Gastroenterology 2025年第8期31卷 152-154页

作者： Nicolò Fabbri Salvatore Greco Antonio Pesce Francesco Virgilio Danila Romeo Carlo V Feo Unit of general Surgery Local Health Agency of FerraraFerrara 44100Emilia-RomagnaItaly Unit of Internal Medicine Local Health Agency of FerraraFerrara 44100Emilia-RomagnaItaly Department of Morphology Surgeryand Experimental MedicineUniversity of FerraraFerrara 44100Emilia-RomagnaItaly Unit of Hepato-Biliary Surgery IRCCS San Raffaele HospitalMilan 20132LombardyItaly Local Health Agency of Ferrara Ferrara 44100Emilia-RomagnaItaly

This article aims to deepen the understanding of the role of Helicobacter pylori(***)infection in the development of cholelithiasis,initiated by the article by Yao et al,who investigated the potential link between *** infection and the development of cholelithiasis through a multicenter retrospective study on an Asian population of over 70000 *** also performed a compre-hensive analysis of previously published studies on *** and cholelithiasis,finding a positive association therein[odds ratio(OR)=1.103,P=0.049].Patients positive for *** also had lower levels of total and direct bilirubin,but higher levels of total cholesterol and low-density lipoprotein cholesterol compared to uninfected patients(P<0.05).Cohort studies have confirmed that *** is a risk factor for cholelithiasis(P<0.0001),and aggregate analyses of case-control and cross-sectional studies have shown a positive association between *** and cholelithiasis in Asia(OR=1.599,P=0.034),but not in Europe(OR=1.277,P=0.246).Moreover,*** appears to be related to a higher ratio of choledocho-lithiasis/cholecystolithiasis(OR=3.321,P=0.033).The authors conclude that *** infection is positively correlated with cholelithiasis,particularly with the choledocholithiasis phenotype,especially in Asia,and it is potentially related to bilirubin and cholesterol metabolism.

关键词： Helicobacter pylori Helicobacter pylori infection Cholelithiasis Proton pump inhibitors Choledocholithiasis

Subtotal gastrectomy for gastric cancer

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World Journal of Gastroenterology 2014年第38期20卷 13667-13680页

作者： Roberto santoro Giuseppe M Ettorre Eugenio santoro Department of general Surgery and Transplantation San CamilloForlanini General Hospital

Although a steady decline in the incidence and mortality rates of gastric carcinoma has been observed in the last century worldwide, the absolute number of new cases/year is increasing because of the aging of the population. So far, surgical resection with curative intent has been the only treatment providing hope for cure; therefore, gastric cancer surgery has become a specialized field in digestive surgery. Gastrectomy with lymph node (LN) dissection for cancer patients remains a challenging procedure which requires skilled, well-trained surgeons who are very familiar with the fast-evolving oncological principles of gastric cancer surgery. As a matter of fact, the extent of gastric resection and LN dissection depends on the size of the disease and gastric cancer surgery has become a patient and “disease-tailored” surgery, ranging from endoscopic resection to laparoscopic assisted gastrectomy and conventional extended multivisceral resections. LN metastases are the most important prognostic factor in patients that undergo curative resection. LN dissection remains the most challenging part of the operation due to the location of LN stations around major retroperitoneal vessels and adjacent organs, which are not routinely included in the resected specimen and need to be preserved in order to avoid dangerous intra- and postoperative complications. Hence, the surgeon is the most important non-TMN prognostic factor in gastric cancer. Subtotal gastrectomy is the treatment of choice for middle and distal-third gastric cancer as it provides similar survival rates and better functional outcome compared to total gastrectomy, especially in early-stage disease with favorable prognosis. Nonetheless, the resection range for middle-third gastric cancer cases and the extent of LN dissection at early stages remains controversial. Due to the necessity of a more extended procedure at advanced stages and the trend for more conservative treatments in early gastric cance

关键词： Gastric cancer Gastrectomy Lymphadenectomy Laparoscopy Endoscopy Quality of life Gastric stump cancer

The Carpal Height Ratio for The Trinidadian Population: What is Normal?

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Open Journal of Orthopedics 2024年第11期14卷 453-460页

作者： Amanda Partap Ian James Persad Ryan Raghunanan san fernando general hospital San Fernando Trinidad West Indies

Aim: To determine the normal carpal height ratio for the Trinidadian population. Design & method: A retrospective review of wrist radiographs performed during the period January 2022 to June 2022 at san fernando general hospital was conducted. A total of 200 radiographs were independently reviewed by two blinded assessors utilizing the PACS system. The carpal height ratio (CHR) and revised carpal height (RCH) ratio was calculated using two methods. A p-value Results: The radiographs reviewed consisted of 94 female and 106 male patients with an age range of 19 to 86 years. The mean CHR was 0.473 and the revised CHR 1.469. The ratio for carpal height as well as the revised CHR was observed to vary amongst the different age groups studied. The CHR and revised CHR for the population was observed to vary based on gender with gender significantly influencing the CHR value (p = 0.001). Conclusions: The CHR of the Trinidadian population as calculated by the data collected falls below the average CHR documented worldwide. However, the interpretation of this value is based on the baseline reference ratio for a population. Therefore, according to our average CHR for our population previous comparison of a CHR index to international figures would have led to erroneous interpretation of results. A decrease in CHR is indicative of carpal collapse. The comparison of CHR to the established normal CHR for the population is believed to allow for early detection of carpal collapse.

关键词： Carpal Collapse Carpal Height Ratio Wrist Degenerative Disease Wrist Pathology Carpal Bone Disease

Diagnosis and treatment of pancreas divisum: A literature review

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Hepatobiliary & Pancreatic Diseases International 2019年第4期18卷 332-336页

作者： Valentina Ferri Emilio Vicente Yolanda Quijano Benedetto Ielpo Hipolito Duran Eduardo Diaz Isabel Fabra Riccardo Caruso Division of general Surgery Sanchinarro Hospital San Pablo University

Background:Pancreas divisum is a congenital embryological disease caused by a lack of fusion between the ventral and dorsal pancreatic ducts in the early stages of *** acute pancreatitis,chronic pancreatitis or chronic abdominal pain are the main clinical syndromes at presentation and occur in only 5%of the patients with pancreas *** review aimed to discuss diagnosis and treatment strategies in patients with symptomatic pancreas *** sources:We report a literature review from 1990 up to January 2018 to explore the various diagnostic modalities and surgical techniques and results reported in the surgical treatment of pancreas ***:There are limited reports available on this topic in the *** analyzed and described the main indications in the treatment of pancreas divisum,focusing on surgical treatment and a discussion of the different ***,we report the results from our experience in two cases of pancreas divisum treated by pancreatic head resection with segmental duodenectomy(the Nakao procedure).Conclusions:Pancreas divisum is a common pancreatic malformation in which only a few patients develop a symptomatic *** treatment is needed in case of endoscopic drainage failure and in cases complicated with chronic pancreatitis and local *** techniques,of greater or lesser complexity,have been proposed.

关键词： Pancreas divisum Duodenal-preserving pancreatectomy Chronic pancreatitis Recurrent acute pancreatitis

Thrombosis of celiacomesenteric trunk:Report of a case

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World Journal of Gastroenterology 2012年第29期18卷 3917-3920页

作者： Federico Lovisetto Gianbattista Finocchiaro De Lorenzi Piera Stancampiano Carmen Corradini Fabio De Cesare Orazio Geraci Mario Manzi Francesco Arceci Division of general and Vascular Surgery San Biagio Hospital28845 DomodossolaItaly Division of general and Vascular Surgery Castelli Hospital28921 VerbaniaItaly

Here we present the case of a 79-year-old woman who complained of acute abdominal pain,vomiting and *** exams demonstrated a severe metabolic *** X-rays showed bowel overdistension and pneumatosis of the stomach *** tomography revealed infarction of the stomach,duodenum and small bowel due to thrombosis of the celiacomesenteric *** laparotomy revealed ischemia of the liver,spleen infarction and necrosis of the gastro-intestinal tube(from the stomach up to the first third of the transverse colon).No further surgical procedures were *** patient died the following *** our knowledge,this is the first reported case about severe gastro-intestinal ischemia due to thrombosis of the celiacomesenteric trunk,a rare anatomic variation of the gastrointestinal vascularisation.

关键词： Celiacomesenteric trunk Celiac trunk Thrombosis Anomalies Gastrointestinal vascularisation

Factors associated with medical device-related pressure ulcers occurrence in hospital setting:a systematic review protocol

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Frontiers of Nursing 2025年第1期12卷 13-18页

作者： Stefano Trapassi Guya Piemonte Enrico Lumini Lorenzo Righi Christian Ramacciani Isemann Mecheroni Silvana Luisa Bertò Stefania Francioni Fulvia Marini Giovanni Becattini Department of Nursing and Midwifery Alta Val d’Elsa HospitalPoggibonsi 53036Italy Department of Nursing and Midwifery Santa Maria Annunziata HospitalBagno a Ripoli 50012Italy Department of Nursing and Midwifery Profession University Hospital CareggiFlorence 50134Italy Department of Nursing and Midwifery Operation Center Medical ServiceSiena 53100Italy Department of Nursing and Midwifery Val di Chiana HospitalMontepulciano 53045Italy Department of Nursing and Midwifery Misericordia HospitalGrosseto 58100Italy Department of Nursing and Midwifery San Donato HospitalArezzo 52100Italy

Objective: To identify the principal factors associated with the occurrence and development of medical device-related pressure injuries (MDRPI) in adults admitted to hospitals. MDRPI, a peculiar subtype of pressure injuries (PI), result from the pression exerted by devices (or their fixation systems) applied for diagnostic and therapeutic purposes. MDRPI represent a serious problem for patients and healthcare systems. Understanding potential risk factors is an important step in implementing effective interventions. Methods: In this study, we will perform a systematic review;if possible, also a meta-analysis will be performed. The review will follow the preferred reporting items for systematic reviews and meta-analyses (PRISMA) reporting guidelines for systematic reviews. A rigorous literature search will be conducted both in electronic databases (Medline/PubMed, Embase, CINAHL, Web of Science, Scopus, Cochrane Library) to identify studies published since 2000 and in gray literature for unpublished studies. Pairs of researchers will identify relevant evidence, extract data, and assess risk of bias independently in each eligible study. Factors associated with the occurrence of MDRPI are considered the primary outcome. Secondary outcomes are prevalence and incidence of MDRPI, length of hospital stay, infections, and death. The evidence will be synthesized using the GRADE methodology. Results: Results are not currently available as this is a protocol for a systematic review. Conclusions: This systematic review will identify evidence on risk factors for developing MDRPI. We are confident that the results of this review will help to improve clinical practice and guide future research.

关键词： incidence medical devices pressure injury pressure ulcer prevalence risk factor

Role of robotic-assisted pancreatic surgery:lessons learned from our initial experience

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Hepatobiliary & Pancreatic Diseases International 2017年第6期16卷 652-658页

作者： Emilio Vicente Yolanda Quijano Benedetto Ielpo Hipolito Duran Eduardo Diaz Isabel Fabra Luis Malave Riccardo Caruso general Surgery Department Sanchinarro University Hospital San Pablo University CEU Madrid Spain

BACKGROUND:Minimally invasive surgery has achieved worldwide acceptance in various fields, however, pancreatic surgery remains one of the most challenging abdominal procedures. In fact, the indication for robotic surgery in pancreatic disease has been controversial. The present study aimed to assess the safety and feasibility of robotic pancreatic ***:We retrospectively reviewed our experience of robotic pancreatic resection done in sanchinarro University hospital. Clinicopathologic characteristics, and perioperative and postoperative outcomes were recorded and ***:From October 2010 to April 2016, 50 patients underwent robotic-assisted surgery for different pancreatic pathologies. All procedures were performed using the da Vinci robotic system. Of the 50 patients, 26 were male and 24 female. The average age of all patients was 62 years. Operative time was 370 minutes. Among the procedures performed were 16 pancreaticoduodenectomies(PD), 23 distal pancreatectomies(DP), 11 tumor enucleations(TE). The mean hospital stay was 17.6 days in PD group, 9.0 days in DP group and 8.4 days in TE group. Pancreatic fistula occurred in 10 cases(20%), 2 after PD, 3 after DP, and 5 after TE. Four patients had postoperative transfusion in PD group and one in DP group. Conversion to open laparotomy occurred in four patients(8%). No serious intraoperative complications were observed. CONCLUSIONS:From our early experience, robotic pancreatic surgery is a safe and feasible procedure. Further experience and follow-up are required to confirm the role of robotic approach in pancreatic surgery.

关键词： robotic surgery pancreatic cancer minimal invasive surgery

Local excision by transanal endoscopic surgery

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World Journal of Gastroenterology 2015年第31期21卷 9286-9296页

作者： Luis J García-Flórez Jorge L Otero-Díez general and Digestive Surgery Service Colorectal UnitHospital San Agustín

Transanal endoscopic surgery(TES) consists of a series of anorectal surgical procedures using different devices that are introduced into the anal canal. TES has been developed significantly since it was first used in the 1980 s. The key point for the success of these techniques is how accurately patients are selected. The main indication was the resection of endoscopically unresectable adenomas. In recent years,these techniques have become more widespread which has allowed them to be applied in conservative rectal procedures for both benign diseases and selected cases of rectal cancer. For more advanced rectal cancers it should be considered palliative or,in some controlled trials,experimental. The role of newer endoscopic techniques available has not yet been defined. TES may allow for new strategies in the treatment of rectal pathology,like transanal natural orifice transluminal endoscopic surgery or total mesorectal excision.

关键词： Transanal endoscopic surgery Rectal adenoma Early

Multiple Chemical Sensitivity: A Sickness of Suffering, Not of Dying. Descriptive Study of 33 Cases

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Health 2025年第1期17卷 65-81页

作者： Blanca Navas-Soler Aarón Gutiérrez-Pastor Antonio Palazón-Bru Jorge Vallejo-Ortega Álex Méndez-Jover Celia santano-Pérez Carmen Seguí-Pérez Marc Seguí-Pérez Sonia Cascant-Pérez Juan Carlos López-Corbalán Míriam Pérez-Cardona Ramón Pérez-Doménech Antonio Hernández-García Patricia Lorca-Amorrich Ana Belén Llinares-Llinares Cristina Valverde-Cámara Rosa María Bustos-Martínez Juan Manuel Núñez-Cruz Isidro Hernández-Isasi José Juan Martínez-Pérez José Manuel santano-López María Dolores Jover-Ríos Juan Méndez-Mora José Miguel Seguí-Ripoll Internal Medicine Service University Hospital of San Juan de Alicante Alicante Spain Family and Community Medicine Service University Hospital of San Juan de Alicante Alicante Spain Foundation for the Promotion of Health and Biomedical Research of the Valencian Community (FISABIO) University Hospital of San Juan de Alicante Alicante Spain Faculty of Physics University of Alicante Alicante Spain Department of Clinical Medicine Medical School University Miguel Hernandez de Elche Alicante Spain CEU Veterinary School University Cardenal Herrera Alfara del Patriarca Campus Valencia Spain Secondary School Marist Brothers High School Alicante Spain Primary Medicine Hospital Francesc Borgia of Gandia Valencia Spain Faculty of Medicine CEU Cardenal Herrera University Alfara del Patriarca Campus Valencia Spain Faculty of Economics University of Alicante Alicante Spain Department of Internal Medicine Hospital La Vega Baja of Orihuela Alicante Spain

Objective: We describe patients with MCS, the evolution of the Quick Environmental Exposure and Sensitivity Inventory (QEESI) score with a special focus on people whose fillings were removed. Methods: We have conducted a retrospective longitudinal cohort study in patients diagnosed with MCS and attended in the outpatient Internal Medicine department of the University hospital of san Juan de Alicante, from January 1, 2008 to January 1, 2021. Sociodemographic, clinical, QEESI and treatment-related variables were collected. We performed descriptive and inferential analyses. Mixed linear models were used to analyze the QEESI. Calculations were carried out with an α error of 5%. Results: Thirty-three patients were included (72.7% women, mean age 56.2). MCS was mainly triggered by mercury (N = 20) and food intolerance (N = 22). The mean interval from symptoms onset was 120 months (SD 81.6). 114 QEESIs were analyzed: 82 (N = 17 without amalgams) and 32 (N = 16 with amalgams). In patients without amalgams, severity scores increased across all subscales except the masking index (vs. with amalgams). Mean scores for the group without amalgams (vs. with amalgams) were: chemical intolerance, 62.8 points (vs. 63.4 and 46.7);other intolerances, 52.7 points (vs. 62.8 and 50.3);symptom severity, 63.2 (vs. 76.7 and 63.3);masking index, 3.9 (vs. 3.2 and 2.8);and life impacts, 63.1 (vs. 58.4 and 49.8). Conclusion: The profile of patient with MCS is a middle-aged woman who is a frequent user of healthcare services, presents a long diagnostic delay and has borne a great personal, work and socioeconomic impact. The QEESI is useful for the clinical follow-up of patients, including the optimal treatment response in the case of amalgams. Clinical Significance: People affected by Multiple Chemical Sensitivity deserve the attention, understanding and help of health professionals and family members, to face an invisible illness for those who do not suffer from it. Support is needed and doctors

关键词： Chemical Sensitivity Electromagnetic Sensitivity Mercury Poisoning Amalgams QEESI