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| 1 | Non-invasive tests for the prediction of primary hepatocellular carcinoma显示文摘Hepatocellular carcinoma(HCC)is one of the most common malignancies in the world and it is one of the main complications of cirrhosis and portal hypertension.Even in the presence of a well-established follow-up protocol for cirrhotic patients,to date poor data are available on predictive markers for primary HCC occurrence in the setting of compensated advanced chronic liver disease patients(cACLD).The gold standard method to evaluate the prognosis of patients with cACLD,beyond liver fibrosis assessed with histology,is the measurement of the hepatic venous pressure gradient(HVPG).An HVPG≥10 mmHg has been related to an increased risk of HCC in cACLD patients.However,these methods are burdened by additional costs and risks for patients and are mostly available only in referral centers.In the last decade increasing research has focused on the evaluation of several,simple,non-invasive tests(NITs)as predictors of HCC development.We reviewed the currently available literature on biochemical and ultrasound-based scores developed for the noninvasive evaluation of liver fibrosis and portal hypertension in predicting primary HCC.We found that the most reliable methods to assess HCC risk were the liver stiffness measurement,the aspartate aminotransferase to platelet ratio index score and the fibrosis-4 index.Other promising NITs need further investigations and validation for different liver disease aetiologies. | Giovanni Marasco Antonio Colecchia Giovanni Silva Benedetta Rossini Leonardo Henry Eusebi Federico Ravaioli Elton Dajti Luigina Vanessa Alemanni Luigi Colecchia Matteo Renzulli Rita Golfieri Davide Festi | 2020 | World Journal of Gastroenterology2020，26，24： | 8 |
| 2 | Arthroscopic vs open ankle arthrodesis:A prospective case series with seven years follow-up显示文摘BACKGROUND The osteoarthritis of the ankle,although less common than other joints,is associated with severe functional limitation.Surgical options are ankle arthroscopic debridement,osteotomies,ankle arthrodesis and ankle arthroplasty.Ankle arthroplasty is increasingly used thanks to the new implants design,but ankle arthrodesis still represents the most used technique and it can be performed arthroscopically or with an open procedure.AIM To compare mid-term results of arthroscopic vs open ankle arthrodesis of patients affected by end-stage ankle arthritis.METHODS This study enrolled 23 patients,which underwent ankle arthrodesis.The patients were divided into 2 groups:group A(open procedure;n=11)and group B(arthroscopic procedure,n=12),the two groups were homogeneous with regard to age and body mass index(P=0.347).The American Orthopaedic Foot and Ankle score(AOFAS),Freiburg Ankle score(FAS)and visual analogue scale for pain intensity were evaluated preoperatively,at six months and at final follow-up of 7.6 years in group A and 7.3 years in group B(P=0.364).RESULTS Patients in the arthroscopic group showed better results at six-month follow-up compared to the open group at the AOFAS(group A,62.2;group B,78.5;P<0.05)and the FAS(group A,61.1;group B,70.3;P=0.015)scores.Pain relief was achieved in both groups at six-month follow-up(group A,1.4;group B,0.9;P=0.162).Both open and arthroscopic groups showed improved clinical outcomes from baseline to final follow-up(P>0.05).Hospital stay was shorter in group B than in group A(P=0.001).More complications were reported in the open group than in the arthroscopic group(P=0.459).CONCLUSION The arthroscopic and the open arthrodesis are valid and safe options for the treatment of ankle arthritis on the basis of clinical outcomes at 7 years follow-up.Moreover,the arthroscopic treatment shows faster improvement at six-month follow-up in comparison with the open group. | Federico Morelli Giorgio Princi Matteo Romano Cantagalli Marco Rossini Ludovico Caperna Daniele Mazza Andrea Ferretti | 2021 | World Journal of Orthopedics2021，12，12： | 3 |
| 3 | Adalimumab efficacy in enteropathic spondyloarthritis: A 12-mo observational multidisciplinary study显示文摘AIM To report adalimumab(Ada) efficacy on articulargastrointestinal disease and health-related quality of life(HRQo L) in patients with enteropathic spondyloarthritis(ES).METHODS A cohort of 52 patients with ES was evaluated in the departments of gastroenterology and internal medicine. At baseline, all patients underwent assessment by an integrated gastro-rheumatologic evaluation of articular and gastrointestinal activity, as well patient reported outcomes(PROs) of the HRQo L questionnaires. After this integrated evaluation and following a specific working flowchart, the Ada anti-tumor necrosis factor(TNF)-inhibitor was assigned to a cohort of 30 patients and its clinical efficacy was evaluated at baseline and after 6-mo and 12-mo treatment by the following tests:(1) Ankylosing Spondylitis Disease Activity ScoreC-Reactive Protein(ASDAS-CRP); Bath Ankylosing Spondylitis Disease Activity Index(BASDAI), Bath Ankylosing Spondylitis Functional Index(BASFI) and Bath Ankylosing Spondylitis Metrology Index(BASMI) for articular activity;(2) Inflammatory Bowel Disease Questionnaire(IBDQ), Crohn's Disease Activity Index(CDAI) and partial Mayo(p Mayo) score for gastrointestinal symptoms and activity; and(3) Health Assessment Questionnaire(HAQ), Patient Global Assessment(PGA) and Short Form-36 health survey(SF-36) questionnaires for PROs of the HRQo L.RESULTS Integrated evaluation and management of the patients affected by ES, carried out simultaneously by a gastroenterologist and a rheumatologist, allowed clinicians to choose the optimal therapeutic strategy. In a cohort of 30 ES patients affected by active articular and gastrointestinal disease, or axial active articular inflammation, Ada led to fast and sustained improvement of both articular and gastrointestinal disease activities. In fact, all the clinimetric evaluation tests exploring articular or gastrointestinal activity, as well as all the HRQo L scores, showed a significant improvement having been achieved at the earliest(6-mo) assessment. This important clinical improvement was maintained at the 12-mo follow-up. Importantly, global and gastrointestinal quality of life significantly correlated with articular disease activity, providing evidence to support that the integrated evaluation is the best option to manage patients with ES.CONCLUSION Ada treatment, upon multidisciplinary(gastrorheumatologic) evaluation, significantly improves both articular and gastrointestinal inflammation, thereby improving the HRQo L in patients affected by ES. | Michele Maria Luchetti Devis Benfaremo Francesco Ciccia Laura Bolognini Monia Ciferri Alessia Farinelli Matteo Rossini Piergiorgio Mosca Giovanni Triolo Armando Gabrielli | 2017 | World Journal of Gastroenterology2017，23，39： | 1 |
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