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| 1 | Efficacy of current guidelines for the treatment of spontaneous bacterial peritonitis in the clinical practice显示文摘AIM: To verify the validity of the International Ascites Club guidelines for treatment of spontaneous bacterial peritonitis (SBP) in clinical practice. METHODS: All SBP episodes occurring in a group of consecutive cirrhotics were managed accordingly and included in the study. SBP was diagnosed when the ascitic fluid polymorphonuclear (PMN) cell count was > 250 cells/mm3, and empirically treated with cefotaxime. RESULTS: Thirty-eight SBP episodes occurred in 32 cirrhotics (22 men/10 women; mean age: 58.6 ± 11.2 years). Prevalence of SBP, in our population, was 17%. Ascitic fluid culture was positive in nine (24%) cases only. Eleven episodes were nosocomial and 71% community-acquired. Treatment with cefotaxime was successful in 59% of cases, while 41% of episodes required a modification of the initial antibiotic therapy because of a less-than 25% decrease in ascitic PMN count at 48 h. Change of antibiotic therapy led to the resolution of infection in 87% of episodes. Among the cases with positive culture, the initial antibiotic therapy with cefotaxime failed at a percentage (44%) similar to that of the whole series. In these cases, the isolated organisms were either resistant or with an inherent insufficient susceptibility to cefotaxime. CONCLUSION: In clinical practice, ascitic PMN count is a valid tool for starting a prompt antibiotic treatment andevaluating its efficacy. The initial treatment with cefotaxime failed more frequently than expected. An increase in healthcare-related infections with antibiotic-resistant pathogens may explain this finding. A different first-line antibiotic treatment should be investigated. | Stefania Angeloni Cinzia Leboffe Antonella Parente Mario Venditti Alessandra Giordano Manuela Merli Oliviero Riggio | 2008 | World Journal of Gastroenterology2008，14，17： | 42 |
| 2 | Moving forward in the treatment of cholangiocarcinoma显示文摘Despite being the second most frequent primary liver tumor in humans,early diagnosis and treatment of cholangiocarcinoma(CCA)are still unsatisfactory.In fact,survival after 5 years is expected in less than one fourth of patients diagnosed with this disease.Rare incidence,late appearance of symptoms and heterogeneous biology are all factors contributing to our limited knowledge of this cancer and determining its poor prognosis in the clinical setting.Several efforts have been made in the last decades in order to achieve an improved classification/understanding with regard to the diverse CCA forms.Location within the biliary tree has helped to distinguish between intrahepatic,perihilar and distal CCA types.Sequence analysis contributed to identifying several characteristic genetic aberrations in CCA that may also serve as possible targets for therapy.Novel findings are expected to significantly improve the management of this malignancy in the near future.In this changing scenario our review focuses on the current and future strategies for CCA treatment.Both systemic and surgical treatments are discussed in detail.The results of the main studies in this field are reported,together with the ongoing trials.The current findings suggest that an integrated multidisciplinary approach to this malignancy would be helpful to improve its outcome. | Tommaso M Manzia Alessandro Parente Ilaria Lenci Bruno Sensi Martina Milana Carlo Gazia Alessandro Signorello Roberta Angelico Giuseppe Grassi Giuseppe Tisone Leonardo Baiocchi | 2021 | World Journal of Gastrointestinal Oncology2021，13，12： | 6 |
| 3 | Accuracy of the automated cell counters for management of spontaneous bacterial peritonitis显示文摘AIM: To evaluate the accuracy of automated blood cell counters for ascitic polymorphonuclear (PMN) determination for: (1) diagnosis, (2) efficacy of the ongoing antibiotic therapy, and (3) resolution of spontaneous bacterial peritonitis (SBP). METHODS: One hundred and twelve ascitic fluid samples were collected from 52 consecutive cirrhotic patients, 16 of them with SBP. The agreement between the manual and the automated method for PMN count was assessed. The sensitivity/specificity and the positive/negative predictive value of the automated blood cell counter were also calculated by considering the manual method as the 'gold standard' . RESULTS: The mean ± SD of the difference between manual and automated measurements was 7.8 ± 58 cells/mm3, while the limits of agreement were +124 cells/mm3 [95% confidence interval (CI): +145 to +103] and -108 cells/mm3 (95% CI: -87 to -129). The automated cell counter had a sensitivity of 100% and a specificity of 97.7% in diagnosing SBP, and a sensitivity of 91% and a specificity of 100% for the efficacy of the ongoing antibiotic therapy. The two methods showed a complete agreement for the resolution of infection. CONCLUSION: Automated cell counters not only have a good diagnostic accuracy, but are also very effective in monitoring the antibiotic treatment in patients with SBP. Because of their quicker performance, they should replace the manual counting for PMN determination in the ascitic fluid of patients with SBP. | Oliviero Riggio Stefania Angeloni Antonella Parente Cinzia Leboffe Giorgio Pinto Teresa Aronne Manuela Merli | 2008 | World Journal of Gastroenterology2008，14，37： | 6 |
| 4 | Outcome of non-variceal acute upper gastrointestinal bleeding in relation to the time of endoscopy and the experience of the endoscopist: A two-year survey显示文摘AIM: To prospectively assess the impact of time of endoscopy and endoscopist's experience on the outcome of non-variceal acute upper gastrointestinal (GI) bleeding patients in a large teaching hospital.METHODS: All patients admitted for non-variceal acute upper GI bleeding for over a 2-year period were potentially eligible for this study. They were managed by a team of seven endoscopists on 24-h call whose experience was categorized into two levels (high and low) according to the number of endoscopic hemostatic procedures undertaken before the study. Endoscopic treatment was standardized according to Forrest classification of lesions as well as the subsequent medical therapy. Time of endoscopy was subdivided into two time periods: routine (8 a.m.-5 p.m.) and on-call (5 p.m.-8 a.m.). For each category of experience and time periods rebleeding rate, transfusion requirement, need for surgery, length of hospital stay and mortality we compared. Multivariate analysis was used to discriminate the impact of different variables on the outcomes that were considered.RESULTS: Study population consisted of 272 patients (mean age 67.3 years) with endoscopic stigmata of hemorrhage. The patients were equally distributed among the endoscopists, whereas only 19% of procedures were done out of working hours. Rockall score and Forrest classification at admission did not differ between time periods and degree of experience.Univariate analysis showed that higher endoscopist's experience was associated with significant reduction in rebleeding rate (14% vs 37%), transfusion requirements (1.8±0.6 vs 3.0±1.7 units) as well as surgery (4% vs 10%), but not associated with the length of hospital stay nor mortality. By contrast, outcomes did not significantly differ between the two time periods of endoscopy.On multivariate analysis, endoscopist's experience was independently associated with rebleeding rate and transfusion requirements. Odds ratios for low experienced endoscopist were 4.47 for rebleeding and 6.90 for need of transfusion after the endoscopy.CONCLUSION: Endoscopist's experience is an important independent prognostic factor for non-variceal acute upper GI bleeding. Urgent endoscopy should be undertaken preferentially by a skilled endoscopist as less expert staff tends to underestimate some risk lesions with a negative influence on hemostasis. | Fabrizio Parente Andrea Anderloni Stefano Bargiggia Venerina Imbesi Emilio Trabucchi Cinzia Baratti Silvano Gallus Gabriele Bianchi Porro | 2005 | World Journal of Gastroenterology2005，11，45： | 4 |
| 5 | Inflammatory bowel disease in an underdeveloped region of Northeastern Brazil显示文摘AIM: To evaluate the demographic characteristics and clinical phenotypes of inflammatory bowel disease(IBD) in a geographic area in Northeastern Brazil.METHODS: This retrospective study was conducted at the Hospital of the Federal University of Piauí in Northeastern Brazil. Demographic characteristics and clinical phenotypes of IBD were analyzed in relation to the time of diagnostic confirmation, which was defined as the date of disease onset. Data were collected between January 2011 and December 2012 and included all census patients 18 years of age or older during that period for whom there was diagnostic confirmation of Crohn's disease(CD), ulcerative colitis(UC), or unclassified colitis according to the Montreal criteria. We also analyzed the period of time between the onset of clinical manifestations and the diagnosis of IBD(delay in the diagnosis). Statistical analyses included means and standard deviations for numeric variables and the Pearson χ2 adherence test for nominal variables. The annual index occurrence and overall prevalence of IBD at our institution were also calculated, with P values < 0.05 indicating statistical significance. This study was approved by the Institutional Ethics and Research Committee.RESULTS: A total of 252 patients with IBD were included, including 152(60.3%) UC patients and 100(39.7%) CD patients. The clinical and demographic characteristics of all patients with IBD showed a female to male ratio of 1.3:1.0 and a mean age of35.2(SD = 14.5) years. In addition, the majority of patients were miscegenated(171, 67.9%), had received higher education(157, 62.4%), lived in urban areas(217, 86.1%), and were under the age of 40 years(97, 62.5%). For patients with CD, according to the Montreal classification, the predominant features present from the onset of disease were an age between 17 and 40 years(A2); colonic disease location(L2); and nonstricturing, nonfistulizing disease behavior(B1). However, approximately one-quarter of all CD patients demonstrated perineal involvement. We also observed considerable delay in the diagnosis of IBD throughout the entire study period(mean = 35.5 mo). In addition, the annual index occurrence rose from 0.08 to 1.53 cases/105 inhabitants/year during the study period, and the prevalence rate was 12.8 cases/105 inhabitants in 2012. Over the last two decades, there was a noted increase in the frequency of IBD in the study area.CONCLUSION: In this study, there was a predominance of patients with UC, young people under 40 years of age, individuals with racial miscegenation, and low annual incomes. | José Miguel Luz Parente Claudio Saddy Rodrigues Coy Viriato Campelo Mírian Perpétua Palha Dias Parente Leonardo Araújo Costa Renata Mendes da Silva Celso Stephan José Murilo Robilotta Zeitune | 2015 | World Journal of Gastroenterology2015，21，4： | 3 |
| 6 | Quality of life, work productivity impairment and healthcare resources in inflammatory bowel diseases in Brazil显示文摘BACKGROUND Inflammatory bowel diseases(IBD)have been associated with a low quality of life(QoL)and a negative impact on work productivity compared to the general population.Information about disease control,patient-reported outcomes(PROs),treatment patterns and use of healthcare resources is relevant to optimizing IBD management.AIM To describe QoL and work productivity and activity impairment(WPAI),treatment patterns and use of healthcare resources among IBD patients in Brazil.METHODS A multicenter cross-sectional study included adult outpatients who were previously diagnosed with moderate to severe Crohn’s disease(CD)or ulcerative colitis(UC).At enrolment,active CD and UC were defined as having a Harvey Bradshaw Index≥8 or a CD Activity Index≥220 or calprotectin>200μg/g or previous colonoscopy results suggestive of inadequate control(per investigator criteria)and a 9-point partial Mayo score≥5,respectively.The PRO assessment included the QoL questionnaires SF-36 and EQ-5D-5L,the Inflammatory Bowel Disease Questionnaire(IBDQ),and the WPAI questionnaire.Information about healthcare resources and treatment during the previous 3 years was collected from medical records.Chi-square,Fisher’s exact and Student’s t-/Mann-Whitney U tests were used to compare PROs,treatment patterns and the use of healthcare resources by disease activity(α=0.05).RESULTS Of the 407 patients in this study(CD/UC:64.9%/35.1%,mean age 42.9/45.9 years,54.2%/56.6%female,38.3%/37.1%employed),44.7%/25.2%presented moderate-to-severe CD/UC activity,respectively,at baseline.Expressed in median values for CD/UC,respectively,the SF-36 physical component was 46.6/44.7 and the mental component was 45.2/44.2,the EQ-visual analog scale score was 80.0/70.0,and the IBDQ overall score was 164.0/165.0.Moderate to severe activity,female gender,being unemployed,a lower educational level and lower income were associated with lower QoL(P<0.05).Median work productivity impairment was 20%and 5%for CD and UC patients,respectively,and activity impairment was 30%,the latter being higher among patients with moderate to severe disease activity compared to patients with mild or no disease activity(75.0%vs 10.0%,P<0.001).For CD/UC patients,respectively,25.4%/2.8%had at least one surgery,38.3%/19.6%were hospitalized,and 70.7%/77.6%changed IBD treatment at least once during the last 3 years.The most common treatments at baseline were biologics(75.3%)and immunosuppressants(70.9%)for CD patients and 5-ASA compounds(77.5%)for UC patients.CONCLUSION Moderate to severe IBD activity,especially among CD patients,is associated with a substantial impact on QoL,work productivity impairment and an increased number of IBD surgeries and hospitalizations in Brazil. | Rogerio Serafim Parra Julio MF Chebli Heda MBS Amarante Cristina Flores Jose ML Parente Odery Ramos Milene Fernandes Jose JR Rocha Marley R Feitosa Omar Feres Antonio S Scotton Rodrigo B Nones Murilo M Lima Cyrla Zaltman Carolina D Goncalves Isabella M Guimaraes Genoile O Santana Ligia Y Sassaki Rogerio S Hossne Mauro Bafutto Roberto LK Junior Mikaell AG Faria Sender J Miszputen Tarcia NF Gomes Wilson R Catapani Anderson A Faria Stella CS Souza Rosana F Caratin Juliana T Senra Maria LA Ferrari | 2019 | World Journal of Gastroenterology2019，25，38： | 2 |
| 7 | Consensus guidelines for the use of bowel preparation prior to colonic diagnostic procedures: colonoscopy and small bowel video capsule endoscopy显示文摘 | Elisabeth Mathus-Vliegen Maria Pellisé Denis Heresbach Wolfgang Fischbach Tricia Dixon Jonathan Belsey Fabrizio Parente Ricardo Rio-Tinto Alistair Brown Ervin Toth Cristiano Crosta Peter Layer Owen Epstein Christian Boustiere | 2013 | Current Medical Research & Opinion2013，，8： | 2 |
| 8 | In vitro toxicity of trichothecene on human erythroblastic progenitors 显示文摘 | Rio B Lautraite S and parent - Massin D | 1997 | Hum Exp Toxicol1997，16，： | 2 |
| 9 | Bowel preparation before colonoscopy in the era of mass screening for colo-rectal cancer: A practical approach显示文摘 | F. Parente B. Marino C. Crosta | 2008 | Digestive and Liver Disease2008，，2： | 2 |
| 10 | Perforin,granzyme B,and FasL expression by peripheral blood T lymphoeytes in emphysema 显示文摘 | Morissette MC Parent J Milot J | 2007 | Respir Res2007，8，： | 1 |
| 11 | New microsatellite markers for the snow crab Chionoecetes opilio (Brachyura:Majidae) 显示文摘 | Puebla O Parent E Svigny J | 2003 | Molecular Ecology Notes2003，3，4： | 1 |
| 12 | Rendering and animation of gaseous phenomena by combining fast volume and seanline a-buffer techniques 显示文摘 | EBERT D S PARENT R E | 1990 | Computer Graphics1990，94，4： | 1 |
| 13 | A decision - making approach显示文摘 | Which child - parent pair will benefit from parental presence during induction of anesthesia | 2006 | Anesth Analy2006，102，1： | 1 |
| 14 | The association betweenScoliosis Research Society-22 scores and scoliosis severitychanges at a clinically relevant threshold显示文摘 | Parent EC Wong D Hill D | 2010 | Spine2010，35，3： | 1 |
| 15 | Mechanism of endothelin-1-induced contraction in rabbit basilar artery显示文摘 | Zubkov AY Rollins KS Parent AD | 2000 | Stroke2000，31，： | 1 |
| 16 | Identification of the role of presenilins beyond Alzheimer's disease显示文摘 | Thinakaran G Parent A T | 2004 | Pharmacol Res2004，50，4： | 1 |
| 17 | Blunted responses to vasoconstrictors in mesenteric vasculature but not in portal vein of spontaneously hypertensive rats treated with relaxin显示文摘 | Massicotte G Parent A St-Louis J | 1989 | Proc Soc Exp Biol Med1989，190，3： | 1 |
| 18 | Akt activity in endometrial cancer ceils : regulation of cell survival through cIAP-1 显示文摘 | Gagnon V St-Germain ME Parent S | 2003 | Int J Oncol2003，23，3： | 1 |
| 19 | Improving the wear resis- tance of white cast iron using a new concept high-entropy microstructure显示文摘 | Wang Y P Li D Y Parent L | 2011 | Wear2011，271，910： | 1 |
| 20 | Interverte-bral disk disease in dogs with signs of back pain alone:25cases(1986-1993)显示文摘 | Sukhiani H R Parent J M Atilola M A O | 1996 | Journal of the American Veterinary Medi-cal Association1996，209，： | 1 |
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