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1Hepatic echinococcosis:Clinical and therapeutic aspects显示文摘Echinococcosis or hydatid disease(HD)is a zoonosis caused by the larval stages of taeniid cestodes belonging to the genus Echinococcus.Hepatic echinococcosis is a life-threatening disease,mainly differentiated into alveolar and cystic forms,associated with Echinoccus multilocularis(E.multilocularis)and Echinococcus granulosus(E.granulosus)infection,respectively.Cystic echinococcosis(CE)has a worldwide distribution,while hepatic alveolar echinococcosis(AE)is endemic in the Northern hemisphere,including North America and several Asian and European countries,like France,Germany and Austria.E.granulosus young cysts are spherical,unilocular vesicles,consisting of an internal germinal layer and an outer acellular layer.Cyst expan-sion is associated with a host immune reaction and the subsequent development of a fibrous layer,called the pericyst;old cysts typically present internal septations and daughter cysts.E.multilocularis has a tumorlike,infiltrative behavior,which is responsible for tissue destruction and finally for liver failure.The liver is the main site of HD involvement,for both alveolar and cystic hydatidosis.HD is usually asymptomatic for a long period of time,because cyst growth is commonly slow;the most frequent symptoms are fatigue and abdominal pain.Patients may also present jaundice,hepatomegaly or anaphylaxis,due to cyst leakage or rupture.HD diagnosis is usually accomplished with the combined use of ultrasonography and immunodiagnosis;furthermore,the improvement of surgical techniques,the introduction of minimally invasive treatments[such as puncture,aspiration,injection,re-aspiration(PAIR)]and more effective drugs(such as benzoimidazoles)have deeply changed life expectancy and quality of life of patients with HD.The aim of this article is to provide an up-todate review of biological,diagnostic,clinical and therapeutic aspects of hepatic echinococcosis.Giuseppe Nunnari Marilia R Pinzone Salvatore Gruttadauria Benedetto M Celesia Giordano Madeddu Giulia Malaguarnera Piero Pavone Alessandro Cappellani Bruno Cacopardo 2012World Journal of Gastroenterology2012,18,13:72
2Gut-liver axis and probiotics: Their role in non-alcoholic fatty liver disease显示文摘The incidence of obesity and its related conditions, including non-alcoholic fatty liver disease(NAFLD), has dramatically increased in all age groups worldwide. Given the health consequences of these conditions, and the subsequent economic burden on healthcare systems, their prevention and treatment have become major priorities. Because standard dietary and lifestyle changes and pathogenically-oriented therapies(e.g., antioxidants, oral hypoglycemic agents, and lipid-lowering agents) often fail due to poor compliance and/or lack of efficacy, novel approaches directed toward other pathomechanisms are needed. Here we present several lines of evidence indicating that, by increasing energy extraction in some dysbiosis conditions or small intestinal bacterial overgrowth,specific gut microbiota and/or a'low bacterial richness'may play a role in obesity,metabolic syndrome,and fatty liver.Under conditions involving a damaged intestinal barrier('leaky gut'),the gut-liver axis may enhance the natural interactions between intestinal bacteria/bacterial products and hepatic receptors(e.g.,toll-like receptors),thus promoting the following cascade of events:oxidative stress,insulinresistance,hepatic inflammation,and fibrosis.We also discuss the possible modulation of gut microbiota by probiotics,as attempted in NAFLD animal model studies and in several pilot pediatric and adult human studies.Globally,this approach appears to be a promising and innovative add-on therapeutic tool for NAFLD in the context of multi-target therapy.Giulia Paolella Claudia Mandato Luca Pierri Marco Poeta Martina Di Stasi Pietro Vajro 2014World Journal of Gastroenterology2014,20,42:55
3Surgical outcome after docetaxel-based neoadjuvant chemotherapy in locally-advanced gastric cancer显示文摘AIM:To investigate feasibility,morbidity and surgical mortality of a docetaxel-based chemotherapy regimen randomly administered before or after gastrectomy in patients suffering from locally-advanced resectable gastric cancer.METHODS:Patients suffering from locally-advanced(T3-4 any N M0 or any T N1-3 M0)gastric carcinoma,staged with endoscopic ultrasound,bone scan,computed tomography,and laparoscopy,were assigned to receive four 21 d/cycles of TCF(docetaxel 75 mg/m 2 day 1,cisplatin 75 mg/m 2 day 1,and fluorouracil 300 mg/m 2 per day for days 1-14),either before(Arm A)or after(Arm B)gastrectomy.Operative morbidity,overall mortality,and severe adverse events were compared by intention-to-treat analysis.RESULTS:From November 1999 to November 2005,70 patients were treated.After preoperative TCF(Arm A),thirty-two(94%)resections were performed,85% of which were R0.Pathological response was complete in 4 patients(11.7%),and partial in 18(55%).No surgical mortality and 28.5%morbidity rate were observed,similar to those of immediate surgery arm(P= 0.86).Serious chemotherapy adverse events tended to be more frequent in arm B(23%vs 11%,P=0.07),with a single death per arm.CONCLUSION:Surgery following docetaxel-based chemotherapy was safe and with similar morbidity to immediate surgery in patients with locally-advanced resectable gastric carcinoma.Roberto Biffi Nicola Fazio Fabrizio Luca Antonio Chiappa Bruno Andreoni Maria Giulia Zampino Arnaud Roth Jan Christian Schuller Giancarla Fiori Franco Orsi Guido Bonomo Cristiano Crosta Olivier Huber 2010World Journal of Gastroenterology2010,16,7:43
4Hepatitis B:Epidemiology and prevention in developing countries显示文摘Hepatitis B virus(HBV)infection is a serious global public health problem.The infection may be transmitted through sexual intercourse,parenteral contact or from an infected mother to the baby at birth and,if contracted early in life,may lead to chronic liver disease,including cirrhosis and hepatocellular carcinoma.On the basis of the HBV carrier rate,the world can be divided in 3 regions of high,medium and low endemicity.The major concern is about high endemicity countries,where the most common route of infection remains vertical transmission from mother to child.Screening of all pregnant women and passive immunization with human hepatitis B immunoglobulin are not affordable for many developing countries.The infection rate can be reduced by modifying behavior,improving individual education,testing all blood donations,assuring asepsis in clinical practice and screening all pregnant women.However,availability of a safe and efficacious vaccine and adoption of appropriate immunization strategies are the most effective means to prevent HBV infection and its consequences.The unsolved problem for poorest countries,where the number of people currently infected is high,is the cost of the vaccine.A future challenge is to overcome the social and economic hurdles of maintaining and improving a prevention policy worldwide to reduce the global burden of the disease.Elisabetta Franco Barbara Bagnato Maria Giulia Marino Cristina Meleleo Laura Serino Laura Zaratti 2012World Journal of Hepatology2012,4,3:39
5Gut microbiota in alcoholic liver disease: Pathogenetic role and therapeutic perspectives显示文摘Alcoholic liver disease(ALD) is the commonest cause of cirrhosis in many Western countries and it has a high rate of morbidity and mortality. The pathogenesis is characterized by complex interactions between metabolic intermediates of alcohol. Bacterial intestinal flora is itself responsible for production of endogenous ethanol through the fermentation of carbohydrates. The intestinal metabolism of alcohol produces a high concentration of toxic acetaldehyde that modifies gut permeability and microbiota equilibrium. Furthermore it causes direct hepatocyte damage. In patients who consume alcohol over a long period, there is a modification of gut microbiota and, in particular, an increment of Gram negative bacteria. This causes endotoxemia and hyperactivation of the immune system. Endotoxin is a constituent of Gram negative bacteria cell walls. Two types of receptors, cluster of differentiation 14 and Toll-like receptors-4, present on Kupffer cells, recognize endotoxins. Several studies have demonstrated the importance of gut-liver axis and new treatments have been studied in recent years to reduce progression of ALD modifying gut microbiota. It has focused attention on antibiotics, prebiotics, probiotics and synbiotics.Giulia Malaguarnera Maria Giordano Giuseppe Nunnari Gaetano Bertino Michele Malaguarnera 2014World Journal of Gastroenterology2014,20,44:30
6Mass-forming pancreatitis: Value of contrast-enhanced ultrasonography显示文摘瞄准:在在集体形成的胰腺炎和胰腺的癌之间的鉴别诊断与第二代的造影剂估计提高对比的 ultrasonography (CEUS ) 的用途。方法:从我们的收音机病理数据库,我们检索了经历了 CEUS 的集体形成的胰腺炎或胰腺的癌影响的所有病人。我们由识别“ parenchymographic ”就在集体形成的胰腺炎和胰腺的肿瘤之间的鉴别诊断的可能性而言在 173 胰腺的群众的学习评估了 CEUS 的结果改进在 CEUS 的动态阶段期间,它为集体形成的胰腺炎被认为诊断。结果:在 CEUS, 94% 集体形成的胰腺炎显示出 intralesional parenchymography。CEUS 有 88.6% 的敏感的集体形成的胰腺炎的允许的诊断, 97.8% 的特性, 91.2% 的积极预兆的价值, 97.1% 的否定预兆的价值,和外套 96% 的精确性。CEUS 显著地在在集体形成的胰腺炎和胰腺的癌之间的鉴别诊断增加了诊断信心,与操作从 0.557 的特性曲线区域的接收装置(P = 0.1608 ) 为到 0.956 的基线美国(P < 0.0001 ) 为 CEUS。结论:CEUS 与 96% 的诊断精确性允许集体形成的胰腺炎的诊断。CEUS 显著地在从胰腺的瘤认出集体形成的胰腺炎关于基础美国增加诊断信心。Mirko D'Onofrio Giulia Zamboni Alessia Tognolini Roberto Malagò Niccolò Faccioli Luca Frulloni Roberto Pozzi Mucelli 2006World Journal of Gastroenterology2006,12,26:28
7Advanced gastric cancer:what we know and what we stillhave to learn显示文摘Gastric cancer is a common neoplastic disease and, more precisely, is the third leading cause of cancer death in the world, with differences amongst geographic areas. The definition of advanced gastric cancer is still debated. Different stadiating systems lead to slightly different stadiation of the disease, thus leading to variations between the single countries in the treatment and outcomes. In the present review all the possibilities of treatment for advanced gastric cancer have been analyzed. Surgery, the cornerstone of treatment for advanced gastric cancer, is analyzed first, followed by an investigation of the different forms and drugs of chemotherapy and radiotherapy. New frontiers in treatment suggest the growing consideration for intraperitoneal administration of chemotherapeutics and combination of traditional drugs with new ones. Moreover, the necessity to prevent the relapse of the disease leads to the consideration of administering intraperitoneal chemotherapy earlier in the therapeutical algorithm.Federico Coccolini Giulia Montori Marco Ceresoli Simona Cima Maria Carla Valli Gabriela E Nita Arianna Heyer Fausto Catena Luca Ansaloni 2016World Journal of Gastroenterology2016,22,3:25
8Coronary thrombus in patients undergoing primary PCI for STEMI:Prognostic significance and management显示文摘Acute ST-elevation myocardial infarction(STEMI) usually results from coronary atherosclerotic plaque disruption with superimposed thrombus formation. Detection of coronary thrombi is a poor prognostic indicator,which is mostly proportional to their size and composition. Particularly,intracoronary thrombi impair both epicardial blood flow and myocardial perfusion,by occluding major coronary arteries and causing distal embolization,respectively. Thus,although primary percutaneous coronary intervention is the preferred treatement strategy in STEMI setting,the associated use of adjunctive antithrombotic drugs and/or percutaneous thrombectomy is crucial to optimize therapy of STEMI patients,by improving either angiographical and clinical outcomes. This review article will focus on the prognostic significance of intracoronary thrombi and on current antithrombotic pharmacological and interventional strategies used inthe setting of STEMI to manage thrombotic lesions.Sabine Vecchio Elisabetta Varani Tania Chechi Marco Balducelli Giuseppe Vecchi Matteo Aquilina Giulia Ricci Lucchi Alessro Dal Monte Massimo Margheri 2014World Journal of Cardiology2014,6,6:18
9Is there a real diagnostic impact of elastosonography and contrast-enhanced ultrasonography in the management of thyroid nodules?显示文摘Ultrasonography(US) and the new applications US elastography(USE) and contrast-enhanced US(CEUS) are used in the screening of thyroid nodules,for which fine-needle aspiration biopsy(FNAB) is the best single diagnostic test.The aim of the study was to compare the sensitivity,specificity,positive predictive value(PPV),and accuracy of the four examinations in nodules with cytological and histological diagnoses.The study used data from US,FNAB,USE(elasticity(ELX 2/1) index),and CEUS(Peak index and time to peak(TTP) index) evaluated in 73 thyroid nodules in 63 consecutive patients likely to undergo surgery.Cytological-histological correlation was available for 38 nodules.No correlation emerged between nodule size and cytological results.A significant(P=0.03) positive correlation between cumulative US findings and cytological results was found.In addition,significant correlations between cumulative US findings and cytology(P=0.02) and between cumulative US findings and histology(P<0.0001) were found.US showed the best specificity and PPV,and FNAB the best sensitivity.There was no significant difference in the ELX 2/1 index,Peak index,or TTP index among nodules subdivided according to cytological scores.No significant correlation was found between ELX 2/1 index,Peak index,and TTP index,on the one hand,and nodule size,US cumulative findings,cytology,and histology on the other hand.The sensitivity of the ELX 2/1 index was high,but its specificity was very low.The accuracy and PPV of USE were lower than those of the other procedures.Only the correlation between Peak index and cumulative US findings reached a value close to significance.Our ultimate aim is to minimise unnecessary thyroidectomy.US and FNAB continue to play a central diagnostic role.The use of a US score showed high specificity and PPV.The specificity of FNAB was low in this selected series because of the numbers of indeterminate cytological responses.USE and CEUS are innovative techniques that need to be standardized.The ELX 2/1 index,Peak index,and TTP index seem to be unrelated to histology.The best statistical data on USE and CEUS concerned their sensitivity and PPV,respectively.At present,USE and CEUS are too time-consuming and of limited utility in selecting patients for surgery.Massimo GIUSTI Davide ORLANDI Giulia MELLE Barbara MASSA Enzo SILVESTRI Francesco MINUTO Gianni TURTULICI 2013Journal of Zhejiang University-Science B(Biomedicine & Biotechnology)2013,14,3:17
10Endoscopic management of esophageal stenosis in children:New and traditional treatments显示文摘Post-esophageal atresia anastomotic strictures and postcorrosive esophagitis are the most frequent types of cicatricial esophageal stricture. Congenital esophageal stenosis has been reported to be a rare but typical disease in children; other pediatric conditions are peptic, eosinophilic esophagitis and dystrophic recessive epidermolysis bullosa strictures. The conservative treatment of esophageal stenosis and strictures(ES) rather than surgery is a well-known strategy for children. Before planning esophageal dilation, the esophageal morphology should be assessed in detail for its length, aspect, number and level, and different conservative strategies should be chosen accordingly. Endoscopic dilators and techniques that involve different adjuvant treatment strategies have been reported and depend on the stricture's etiology, the availability of different tools and the operator's experience and preferences. Balloon and semirigid dilators are the most frequently used tools. No high-quality studies have reported on the differences in the efficacies and rates of complications associated with these two types of dilators. There is no consensus in the literature regarding the frequency of dilations or the diameter that should be achieved. The use of adjuvant treatments has been reported in cases of recalcitrant stenosis or strictures with evidence of dysphagic symptoms. Corticosteroids(either systemically or locally injected), the local application of mitomycin C, diathermy and laser ES sectioning have been reported. Some authors have suggested that stenting can reduce both the number of dilations and the treatment length. In many cases, this strategy is effective when either metallic or plastic stents are utilized. Treatment complications, such esophageal perforations, can be conservatively managed, considering surgery only in cases with severe pleural cavity involvement. In cases of stricture relapse,even if such relapses occur following the execution of well-conducted conservative strategies, surgical stricture resection and anastomosis or esophageal substitution are the only remaining options.Luigi Dall rsquo Oglio Tamara Caldaro Francesca Foschia Simona Faraci Giovanni Federici di Abriola Francesca Rea Erminia Romeo Filippo Torroni Giulia Angelino Paola De Angelis 2016World Journal of Gastrointestinal Endoscopy2016,8,4:16
11Liver metastases:Contrast-enhanced ultrasound compared with computed tomography and magnetic resonance显示文摘The development of ultrasound contrast agents with excellent tolerance and safety profiles has notably improved liver evaluation with ultrasound(US)for several applications,especially for the detection of metastases.In particular,contrast enhanced ultrasonography(CEUS)allows the display of the parenchymal microvasculature,enabling the study and visualization of the enhancement patterns of liver lesions in real time and in a continuous manner in all vascular phases,which is similar to contrast-enhanced computed tomography(CT)and contrast-enhanced magnetic resonance imaging.Clinical studies have reported that the use of a contrast agent enables the visualization of more metastases with significantly improved sensitivity and specificity compared to baseline-US.Furthermore,studies have shown that CEUS yields sensitivities comparable to CT.In this review,we describe the state of the art of CEUS for detecting colorectal liver metastases,the imaging features,the literature reports of metastases in CEUS as well as its technique,its clinical role and its potential applications.Additionally,the updated international consensus panel guidelines are reported in this review with the inherent limitations of this technique and best practice experiences.Vito Cantisani Hektor Grazhdani Cristina Fioravanti Maria Rosignuolo Fabrizio Calliada Daniela Messineo Maria Giulia Bernieri Adriano Redler Carlo Catalano Ferdinando D’Ambrosio 2014World Journal of Gastroenterology2014,20,29:16
12Autoimmune pancreatitis:Multimodality non-invasive imaging diagnosis显示文摘Autoimmune pancreatitis(AIP)is characterized by obstructive jaundice,a dramatic clinical response to steroids and pathologically by a lymphoplasmacytic infiltrate,with or without a pancreatic mass.Type 1AIP is the pancreatic manifestation of an Ig G4-related systemic disease and is characterized by elevated Ig G4serum levels,infiltration of Ig G4-positive plasma cells and extrapancreatic lesions.Type 2 AIP usually has none or very few Ig G4-positive plasma cells,no serum Ig G4 elevation and appears to be a pancreas-specific disorder without extrapancreatic involvement.AIP is diagnosed in approximately 2%-6%of patients that undergo pancreatic resection for suspected pancreatic cancer.There are three patterns of autoimmune pancreatitis:diffuse disease is the most common type,with a diffuse,'sausage-like'pancreatic enlargement with sharp margins and loss of the lobular contours;focal disease is less common and manifests as a focal mass,often within the pancreatic head,mimicking a pancreatic malignancy.Multifocal involvement can also occur.In this paper we describe the features of AIP at ultrasonography,computed tomography,magnetic resonanceand positron emission tomography/computed tomography imaging,focusing on diagnosis and differential diagnosis with pancreatic ductal adenocarcinoma.It is of utmost importance to make an early correct differential diagnosis between these two diseases in order to identify the optimal therapeutic strategy and to avoid unnecessary laparotomy or pancreatic resection in AIP patients.Non-invasive imaging plays also an important role in therapy monitoring,in follow-up and in early identification of disease recurrence.Stefano Crosara Mirko D'Onofrio Riccardo De Robertis Emanuele Demozzi Stefano Canestrini Giulia Zamboni Roberto Pozzi Mucelli 2014World Journal of Gastroenterology2014,20,45:16
13Intragenic antagonistic roles of protein and circRNA in tumorigenesis显示文摘circRNAs arise from back splicing events during mRNA processing, and when deregulated can play an active role in cancer. Here we characterize a new circRNA (circPOK) encoded by the Zbtb7a gene (also kown as POKEMON, LRF) in the context of mesenchymal tumor progression. circPOK functions as a non-coding proto-oncogenic RNA independently and antithetically to its linear transcript counterpart, which acts as a tumor suppressor by encoding the Pokemon transcription factor. We find that circPOK regulates pro-proliferative and pro-angiogenic factors by co-activation of the ILF2/3 complex. Importantly, the expression of Pokemon protein and circRNA is aberrantly uncoupled in cancer through differential post-transcriptional regulation. Thus, we identify a novel type of genetic unit, the iRegulon, that yields biochemically distinct RNA products, circular and linear, with diverse and antithetical functions. Our findings further expand the cellular repertoire towards the control of normal biological outputs, while aberrant expression of such components may underlie disease pathogenesis including cancer.Jlenia Guarnerio Yang Zhang Giulia Cheloni Riccardo Panella Jesse Mae Katon Mark Simpson Akinobu Matsumoto Antonella Papa Cristian Loretelli Andreas Petri Sakari Kauppinen Cassandra Garbutt Gunnlaugur Petur Nielsen Vikram Deshpande Mireia Castillo-Martin Carlos Cordon-Cardo Spentzos Dimitrios John G. Clohessy Mona Batish Pier Paolo Pandolfi 2019Cell Research2019,29,8:15
14Differences between main-duct and branch-duct intraductal papillary mucinous neoplasms of the pancreas显示文摘In the last decade,intraductal papillary mucinous neoplasms(IPMNs) have become commonly diagnosed.From a morphological standpoint,they are classified in main-duct IPMNs(MD-IPMNs) and branch-duct IPMNs(BD-IPMNs),depending on the type of involvement of the pancreatic ductal system by the neoplasm.Despite the fact that our understanding of their natural history is still incomplete,recent data indicate that MD-IPMNs and BD-IPMNs show significant differences in terms of biological behaviour with MD-IPMNs at higher risk of malignant degeneration.In the present paper,clinical and epidemiological characteristics,rates of malignancy and the natural history of MD-IPMNs and BD-IPMNs are analyzed.The profile of IPMNs involving both the main pancreatic duct and its side branches(combined-IPMNs) are also discussed.Finally,general recommendations for management based on these differences are given.Roberto Salvia Stefano Crippa Stefano Partelli Giulia Armatura Giuseppe Malleo Marina Paini Antonio Pea Claudio Bassi 2010World Journal of Gastrointestinal Surgery2010,2,10:14
15Acute appendicitis: Epidemiology, treatment and outcomesanalysis of 16544 consecutive cases显示文摘AIM To investigate the epidemiology,treatment and outcomes of acute appendicitis(AA) in a large population study.METHODS This is a retrospective cohort study derived from the administrative dataset of the Bergamo district healthcare system(more than 1 million inhabitants) from 1997 to 2013.Data about treatment,surgery,length of stay were collected.Moreover for each patients were registered data about relapse of appendicitis and hospital admission due to intestinal obstruction.RESULTS From 1997 to 2013 in the Bergamo district we collected 16544 cases of AA,with a crude incidence rate of 89/100000 inhabitants per year; mean age was 24.51 ± 16.17,54.7% were male and the mean Charlson's comorbidity index was 0.32 ± 0.92.Mortality was < 0.0001%.Appendectomy was performed in 94.7% of the patients and the mean length of stay was 5.08 ± 2.88 d; the cumulative hospital stay was 5.19 ± 3.36 d and 1.2% of patients had at least one further hospitalization due intestinal occlusion.Laparoscopic appendectomy was performed in 48% of cases.Percent of 5.34 the patients were treated conservatively with a mean length of stay of 3.98 ± 3.96 d; the relapse rate was 23.1% and the cumulative hospital stay during the study period was 5.46 ± 6.05 d.CONCLUSION The treatment of acute appendicitis in Northern Italy is slowly changing,with the large diffusion of laparoscopic approach; conservative treatment of non-complicated appendicitis is still a neglected option,but rich of promising results.Marco Ceresoli Alberto Zucchi Niccolò Allievi Asaf Harbi Michele Pisano Giulia Montori Arianna Heyer Gabriela E Nita Luca Ansaloni Federico Coccolini 2016World Journal of Gastrointestinal Surgery2016,8,10:14
16Activation of Defense Response Pathways by OGs and Fig22 Elicitors in Arabidopsis Seedlings显示文摘Carine Denoux Roberta Galletti Nicole Mammarella Suresh Gopalan Danièle Werck Giulia De Lorenzo Simone Ferrari Frederick M. Ausubel Julia Dewdney 2008Molecular Plant2008,1,3:13
17Effects of music and music therapy on mood in neurological patients显示文摘Mood disorder and depressive syndromes represent a common comorbid condition in neurological disorders witha prevalence rate that ranges between 20% and 50% of patients with stroke, epilepsy, multiple sclerosis, and Parkinson's disease. Notwithstanding, these conditions are often under-diagnosed and under-treated in the clinical practice and negatively affect the functional recovery, the adherence to treatment, the quality of life, and even the mortality risk. In addition, a bidirectional association between depression and neurological disorders may be possible being that depressive syndromes may be considered as a risk factor for certain neurological diseases. Despite the large amount of evidence regarding the effects of music therapy(MT) and other musical interventions on different aspects of neurological disorders, no updated article reviewing outcomes such as mood, emotions, depression, activity of daily living and so on is actually available; for this reason, little is known about the effectiveness of music and MT on these important outcomes in neurological patients. The aim of this article is to provide a narrative review of the current literature on musical interventions and their effects on mood and depression in patients with neurological disorders. Searching on Pub Med and Psyc Info databases, 25 studies corresponding to the inclusion criteria have been selected; 11 of them assess the effects of music or MT in Dementia, 9 explore the efficacy on patients with Stroke, and 5 regard other neurological diseases like Multiple Sclerosis, Amyotrophic Lateral Sclerosis/motor neuron disease, Chronic quadriplegia, Parkinson's Disease, and Acquired Brain dysfunctions. Selected studies are based on relational and rehabilitative music therapy approaches or concern music listening interventions. Most of the studies support the efficacy of MT and other musical interventions on mood, depressive syndromes, and quality of life on neurological patients.Alfredo Raglio Lapo Attardo Giulia Gontero Silvia Rollino Elisabetta Groppo Enrico Granieri 2015World Journal of Psychiatry2015,5,1:13
18Simultaneous intraductal papillary neoplasms of the bile duct and pancreas treated with chemoradiotherapy显示文摘Some authors have suggested that intraductal papillary mucinous neoplasms of the bile duct(IPMN-B) could be the the biliary counterpart of IPMN of the pancreas(IPMN-P) since they share several clinical-pathological features.These include prominent intraductal papil-lary proliferation pattern,a gastrointestinal phenotype,frequent mucin hyper-secretion and progression to mu-cinous carcinoma.To date there are just four reported cases of patients with synchronous IPMN-B and IPMN-P all of which were treated surgically.We hereby report the case of a 76-year-old woman who was incidentally diagnosed with both an asymptomatic 3 cm bulky uid lesion obstructing the bile duct lumen,diagnosed as a malignant IPMN-B,and synchronous multiple pancreatic cystic lesions(10-13 mm) communicating with an irreg-ular Wirsung,diagnosed as branch duct IPMN-P.Since surgery was ruled-out because of the patient's age and preferences,she underwent a conservative manage-ment regimen comprising both chemotherapy and radio-therapy.This was effective in decreasing the mass size and in resolving subsequent jaundice.This is also the f irst reported case of IPMN-B successfully treated with chemoradiotherapy.Clinicians should consider medical treatment as an option in this clinical scenario,in pa-tients who may be unf it for surgery.Roberto Valente Gabriele Capurso Paola Pierantognetti Elsa Iannicelli Matteo Piciucchi Adriana Romiti Paolo Mercantini Alberto Larghi Giulia Francesca Federici Viola Barucca Maria Falchetto Osti Emilio Di Giulio Vincenzo Ziparo Gianfranco Delle Fave 2012World Journal of Gastrointestinal Oncology2012,4,2:13
19Therapeutic and clinical aspects of portal vein thrombosis in patients with cirrhosis显示文摘Portal vein thrombosis(PVT) is a frequent complication in cirrhosis, particularly in advanced stages of the disease. As for general venous thromboembolism, risk factors for PVT are slow blood flow, vessel wall damage and hypercoagulability, all features of advanced cirrhosis. Actually, the old dogma of a hemorrhagic tendency in cirrhosis has been challenged by new laboratory tools and the clinical evidence that venous thrombosis also occurs in cirrhosis. The impaired hepatic synthesis of both pro- and anticoagulants leads to a rebalanced hemostasis, more liable to be tipped towards thrombosis or even bleeding. Conventional anticoagulant drugs(low molecular weight heparin or vitamin K antagonists) may be used in cirrhosis patients with PVT, particularly in those eligible for liver transplantation, to prevent thrombosis progression thus permitting/facilitating liver transplant. However, several doubts exist on the level of anticoagulation achieved as estimated by coagulation tests, on the efficacy of treatment monitoring and on the correct timing for discontinuation in non-transplant candidates, while in transplant candidates there is expert consensus on continuing anticoagulation until transplantation. The recent introduction of direct acting oral anticoagulant drugs(DOACs) in other clinical settings generates much interest on their possible application in patients with cirrhosis and PVT. However, DOACs were not evaluated yet in patients with liver disease and cannot be recommended for the present time.Massimo Primignani Giulia Tosetti Vincenzo La Mura 2015World Journal of Hepatology2015,7,29:13
20Silybin counteracts lipid excess and oxidative stress in cultured steatotic hepatic cells显示文摘AIM: To investigate in vitro the therapeutic effect and mechanisms of silybin in a cellular model of hepatic steatosis.METHODS: Rat hepatoma Fa O cells were loaded with lipids by exposure to 0.75 mmol/L oleate/palmitate for 3 h to mimic liver steatosis. Then, the steatotic cells were incubated for 24 h with different concentrations(25 to 100 μmol/L) of silybin as phytosome complex with vitamin E. The effects of silybin on lipid accumulation and metabolism, and on indices of oxidative stress were evaluated by absorption and fluorescence microscopy, quantitative real-time PCR, Western blot, spectrophotometric and fluorimetric assays.RESULTS: Lipid-loading resulted in intracellular triglyceride(TG) accumulation inside lipid droplets, whose number and size increased. TG accumulation was mediated by increased levels of peroxisome proliferator-activated receptors(PPARs) and sterol regulatory element-binding protein-1c(SREBP-1c). The lipid imbalance was associated with higher production of reactive oxygen species(ROS) resulting in increased lipid peroxidation, stimulation of catalase activity and activation of nuclear factor kappa-B(NF-κB). Incubation of steatotic cells with silybin 50 μmol/L significantly reduced TG accumulation likely by promoting lipid catabolism and by inhibiting lipogenic pathways, as suggested by the changes in carnitine palmitoyltransferase 1(CPT-1), PPAR and SREBP-1c levels. The reduction in fat accumulation exerted by silybin in the steatotic cells was associated with the improvement of the oxidative imbalance caused by lipid excess as demonstrated by the reduction in ROS content, lipid peroxidation, catalase activity and NF-κB activation.CONCLUSION: We demonstrated the direct antisteatotic and anti-oxidant effects of silybin in steatotic cells, thus elucidating at a cellular level the encouraging results demonstrated in clinical and animal studies.Giulia Vecchione Elena Grasselli Adriana Voci Francesca Baldini Ignazio Grattagliano David QH Wang Piero Portincasa Laura Vergani 2016World Journal of Gastroenterology2016,22,26:13
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