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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 rate.In the united States,and different countries in Europe,organized population screenings exist and include people between 50 and 74 years of age.These screenings have allowed an early diagnosis and consequently an improvement in health indicators.colon 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 mortality.This 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 cRc.Finally,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

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 females.However,it is not known whether sex differences in RoP affect all degrees of the condition,are global and have changed as neonatology has developed.We aimed to conduct a systematic review and meta-analysis of studies addressing sex differences in the risk of developing RoP.Methods PubMed/MEDLINE and Embase databases were searched.The frequentist,random-effects risk ratio(RR)and 95%confidence interval(cI)were calculated.Bayesian 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 index.conclusions our study confirms the presence of a male disadvantage in severe RoP but not in less severe forms of the disease.There 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

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 inflammation.Biomarkers for the early assessment of chronic disorders encompass acute phase proteins(APP),cytokines and chemokines,pro-inflammatory enzymes,lipids and oxidative stress mediators.These substances enter saliva through the blood flow and,in some cases。

关键词： inflammation acute chronic

Severe chronic diarrhea and maculopapular rash:A case report

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World Journal of Gastroenterology 2011年第34期17卷 3948-3952页

作者： Alessandra Elvevi Federica Grifoni Federica Branchi umberto Gianelli Dario conte Gastrointestinal unit 2 Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico and University of Milan Federica Grifoni Hematology Unit Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico and University of Milan umberto Gianelli Department of Pathology Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico and University of Milan

Systemic mastocytosis (SM) is a heterogeneous disease of the bone marrow characterized by abnormal growth, accumulation and activation of clonal mast cells (Mcs). We report a case of SM with multiorgan involvement. A 30-year-old man presented with diarrhea, flushing, maculopapular rash with itching and weight loss. The upper and lower gastrointestinal endoscopies showed macroscopic involvement of stomach and duodenum; mucosal samples from stomach, duodenum, colon and distal ileum showed mucosal inf iltration by large, spindleshaped Mcs with abnormal surface molecule expression (cD2 and cD25), a picture fully consistent with SM, according to the World Health organization diagnostic criteria. A computed tomography scan showed diffuse lymphadenopathy, hepatosplenomegaly and diffuse small bowel involvement. Bone marrow aspirate and biopsy were diagnostic for SM; serum tryptase levels were increased (209 ng/mL, normal values 20 ng/mL). The conclusive diagnosis was smouldering SM. There wereno therapeutic indications except for treatment of symptoms. The patient was strictly followed up because of the risk of aggressive evolution.

关键词：慢性腹泻丘疹世界卫生组织肥大细胞异常生长十二指肠淋巴结肿大计算机断层

Helicobacter pylori-negative Russell body gastritis:case report

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World Journal of Gastroenterology 2011年第9期17卷 1234-1236页

作者： Alessandro Del Gobbo Luca Elli Paola Braidotti Franca Di Nuovo Silvano Bosari Solange Romagnoli Department of Medicine Surgery and DentistryDivision of PathologyA.O.San Paolo and Fondazione IRCCS Cà-Granda Ospedale Maggiore PoliclinicoUniversity of Milan Medical School center for Prevention and Diagnosis of celiac Disease Fondazione IRCCS Cà-Granda Ospedale Maggiore PoliclinicoUniversity of Milan Pathology unit A.O.G.Salvini20024 Garbagnate MilaneseItaly

Russell body gastritis is an unusual form of chronic gastritis characterized by the permeation of lamina propria by numerous plasma cells with eosinophilic cytoplasmic inclusions.Very few cases have been reported in the literature;the majority of which have shown Helicobacter Pylori(H.pylori)infection,thus suggesting a correlation between plasma cell presence and antigenic stimulation by H.pylori.We present a case of Russell body gastritis in a 78-year-old woman who was undergoing esophagogastroduodenoscopy for epigastric pain.Gastric biopsy of the gastroesophageal junction showed the presence of cells with periodic acid-Schiff-positive hyaline pink bodies.Giemsa staining for H.pylori infection was nega-tive,as well as immunohistochemical detection.The cells with eosinophilic inclusions stained positive for cD138,cD79a,andκand lambda light chains,which confirmed plasma cell origin.In particular,κand lambda light chains showed a polyclonal origin and the patient was negative for immunological dyscrasia.The histological observations were confirmed by ultrastructural examination.The cases reported in the literature associated with H.pylori infection have shown regression of plasma cells after eradication of H.pylori.Nothing is known about the progression of H.pylori-negative cases.The unusual morphological appearance of this type of chronic gastritis should not be misinterpreted during routine examination,and it should be distinguished from other common forms of chronic gastritis.It is mandatory to exclude neoplastic diseases such as gastric carcinoma, lymphoma and plasmocytoma by immunohistochemistry and electron microscopy,which can help with differential diagnosis.The long-term effects of plasma cells hyperactivation are still unknown,because cases of gastric tumor that originated in patients affected by Russell body gastritis have not been described in the literature.We are of the opinion that these patients should be scheduled for endoscopic surveillance.

关键词：幽门螺杆菌慢性胃炎病例报告罗素阴性嗜酸性粒细胞免疫组化检测姬姆萨染色

Diagnostic and therapeutic implications of the association between ferritin level and severity of nonalcoholic fatty liver disease

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World Journal of Gastroenterology 2012年第29期18卷 3782-3786页

作者： Luca Valenti Paola Dongiovanni Silvia Fargion università degli Studi di Milano Fondazione Ca' Granda IRCCS Ospedale Maggiore Policlinico20122 MilanoItaly

Nonalcoholic fatty liver disease(NAFLD),defined by excessive liver fat deposition related to the metabolic syndrome,is a leading cause of progressive liver disease,for which accurate non-invasive staging systems and effective treatments are still lacking.Evidence has shown that increased ferritin levels are associated with the metabolic insulin resistance syndrome,and higher hepatic iron and fat content.Hyperferritinemia and iron stores have been associated with the severity of liver damage in NAFLD,and iron depletion reduced insulin resistance and liver enzymes.Recently,Kowdley et al demonstrated in a multicenter study in 628 adult patients with NAFLD from the NAFLD-clinical research network database with central re-evaluation of liver histology and iron staining that the increased serum ferritin level is an independent predictor of liver damage in patients with NAFLD,and is useful to identify NAFLD patients at risk of non-alcoholic steatohepatitis and advanced fibrosis.These data indicate that incorporation of serum ferritin level may improve the performance of noninvasive scoring of liver damage in patients with NAFLD,and that iron depletion still represents an attractive therapeutic target to prevent the progression of liver damage in these patients.

关键词：脂肪含量蛋白水平严重程度酒精性血清铁肝病治疗肝功能损害

Paradoxical association between dyspepsia and autoimmune chronic atrophic gastritis:Insights into mechanisms,pathophysiology,and treatment options

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World Journal of Gastroenterology 2023年第23期29卷 3733-3747页

作者： Roberta Elisa Rossi Alessandra Elvevi Valentina Sciola Francesco Vito Mandarino Silvio Danese Pietro Invernizzi Sara Massironi Gastroenterology and Endoscopy unit IRCCS Humanitas Research HospitalRozzano 20089MilanItaly Gastroenterology unit Fondazione IRCCS San Gerardo dei TintoriMonza 20900Italy and Department of Medicine and SurgeryUniversity of Milano-BicoccaMonza 20900Italy Gastroenterology and Endoscopy unit Fondazione IRCCS Ca’Granda Ospedale Maggiore PoliclinicoMilano 20100Italy Department of Gastroenterology and Endoscopy IRCCS Ospedale San RaffaeleMilan 20132Italy School of Medicine Vita-Salute San Raffaele UniversityMilan 20132Italy

BAcKGRouND Autoimmune gastritis(AIG)is a progressive,chronic,immune-mediated inflammatory disease characterized by the destruction of gastric parietal cells leading to hypo/anacidity and loss of intrinsic factor.Gastrointestinal symptoms such as dyspepsia and early satiety are very common,being second in terms of frequency only to anemia,which is the most typical feature of AIG.AIM To address both well-established and more innovative information and knowledge about this challenging disorder.METHoDS An extensive bibliographical search was performed in PubMed to identify guidelines and primary literature(retrospective and prospective studies,systematic reviews,case series)published in the last 10 years.RESuLTS A total of 125 records were reviewed and 80 were defined as fulfilling the criteria.coNcLuSIoN AIG can cause a range of clinical manifestations,including dyspepsia.The pathophysiology of dyspepsia in AIG is complex and involves changes in acid secretion,gastric motility,hormone signaling,and gut microbiota,among other factors.Managing dyspeptic symptoms of AIG is challenging and there are no specific therapies targeting dyspepsia in AIG.While proton pump inhibitors are commonly used to treat dyspepsia and gastroesophageal reflux disease,they may not be appropriate for AIG.Prokinetic agents,antidepressant drugs,and non-pharmacological treatments may be of help,even if not adequately evidence-based supported.A multidisciplinary approach for the management of dyspepsia in AIG is recommended,and further research is needed to develop and validate more effective therapies for dyspepsia.

关键词： Dyspepsia Dyspeptic symptoms Gastro-intestinal symptoms Autoimmune gastritis chronic autoimmune atrophic gastritis Treatment

Is there still a role for the hepatic locoregional treatment of metastatic neuroendocrine tumors in the era of systemic targeted therapies?

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World Journal of Gastroenterology 2017年第15期23卷 2640-2650页

作者： Federica cavalcoli Emanuele Rausa Dario conte Antonio Federico Nicolini Sara Massironi Gastro-enterology and Endoscopy unit Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico Postgraduate School of Gastroenterology Department of Pathophysiology and TransplantationUniversitàdegli Studi di Milano Department of colorectal Diseases St.Vincent's University Hospital Department of Interventional Radiology Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico

Gastroenteropancreatic neuroendocrine neoplasms(GEP-NENs) frequently present with distant metastases at the time of diagnosis and the liver is the most frequent site of spreading. The early identification of metastatic disease represents a major prognostic factor for GEP-NENs patients. Radical surgical resection, which is feasible for a minority of patients, is considered the only curative option, while the best management for patients with unresectable liver metastases is still being debated. In the last few years, a number of locoregional and systemic treatments has become available for GEP-NEN patients metastatic to the liver. However, to date only a few prospective studies have compared those therapies and the optimal management option is based on clinical judgement. Additionally, locoregional treatments appear feasible and safe for disease control for patients with limited liver involvement and effective in symptoms control for patients with diffuse liver metastases. considering the lack of randomized controlled trials comparing the locoregional treatments of liver metastatic NEN patients, clinical judgment remains key to set the most appropriate therapeutic pathway. Prospective data may ultimately lead to more personalized and optimized treatments. The present review analyzes all the locoregional therapy modalities(i.e., surgery, ablative treatments and transarterial approach) and aims to provide clinicians with a useful algorithm to best treat GEP-NEN patients metastatic to the liver.

关键词： Gastroenteropancreatic neuroendocrine 瘤肝转移 Locoregional 治疗全身的治疗脱离 chemoembolization

orthostatic hypotension,an often-neglected problem in community-dwelling older people:discrepancies between studies and real life

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Journal of Geriatric cardiology 2018年第10期15卷 644-646页

作者： Sarah Damanti Dario consormi Annalisa Valentini Benedetta cerasoli Martina Biotto Federica conti Marta clerici Pasqualina Iannuzzi Emanuela Manzo Paolo D Rossi Simona ciccone Matteo cesari Geriatric unit Fondazione IRCCS Ca'Granda Ospedale Maggiore PoliclinicoMilanltaly Department of clinical Sciences and community Health University of MilanMilanItaly unit of Epidemiology Fondazione IRCCS Ca'Granda Ospedale Maggiore PoliclinicoMilanltaly Fellowship in Geriatrics and Gerontology University of MilanMilanItaly

orthostatic hypotension (oH)is a common condition in older persons.According to the 2011criteria,oH is defined by a sustained reduction of systolic blood pressure of 20 mmHg or a 10mmHg-fall of diastolic blood pressure,[1] Its prevalence increases with age and according to a recent systematic review the pooled prevalence in community dwelling older people is 22.2%.[2]Although oH is largely explained by concurrent clinical conditions (in particular, hypertension,diabetes,malnutrition,vascular encephalopa- thy,anemia,Parkinson's disease)[3],aging per se determines a series of physiological dysfunctions potentially representing its biological substratum (e.g.,reduction in barore- flex-mediated cardiovascular function,altered salt and water balance at renal level,impaired cardiac diastolic filling).It is also noteworthy that age-related changes in pharmacokinetic and pharmacodynamic mechanisms of drugs (especially in the context of polypharmacy)also increase the risk of oH.

关键词： Elderly orthostatic hypotension Prevalence Real-life