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| 1 | 欧洲新生儿呼吸窘迫综合征防治共识指南:2016版显示文摘新生儿呼吸窘迫综合征(RDS)是早产儿的重要疾病,尽管治疗手段不断成熟,低龄早产儿存活率逐渐增高,但支气管肺发育不良(BPD)发病率也随之升高,其中部分原因是减少了出生后激素的使用.2006年以来,来自欧洲许多国家的新生儿专家每3年一次回顾最新文献,就RDS或有RDS风险早产儿的防治达成共识,立志于改善欧洲新生儿的预后.欧洲RDS防治指南2007年开始发布,2010年和2013年进行了更新,期间获得了欧洲围产医学学会的大力支持.RDS是由于肺表面活性物质(PS)缺乏导致生后早期出现呼吸窘迫,典型临床表现随着防治手段的改进发生了巨大变化. | DavidG.Sweet Virgilio Carnielli Gorm Greisen Mikko Hallman Eren Ozek Richard Plavka Ola Didrik Saugstad Umberto Simeoni Christian P. Speer Maximo Vento Gerard H. A. Visser Henry L. Halliday | 2017 | 中华儿科杂志2017，55，3： | 90 |
| 2 | Predictive factors for anastomotic leakage after laparoscopic colorectal surgery显示文摘Every colorectal surgeon during his or her career is faced with anastomotic leakage(AL); one of the most dreaded complications following any type of gastrointestinal anastomosis due to increased risk of morbidity, mortality, overall impact on functional and oncologic outcome and drainage on hospital resources. In order to understand and give an overview of the AL risk factors in laparoscopic colorectal surgery, we carried out a careful review of the existing literature on this topic and found several different definitions of AL which leads us to believe that the lack of a consensual, standard definition can partly explain the considerable variations in reported rates of AL in clinical studies. Colorectal leak rates have been found to vary depending on the anatomic location of the anastomosis with reported incidence rates ranging from 0 to 20%, while the laparoscopic approach to colorectal resections has not yet been associated with a significant reduction in AL incidence. As well, numerous risk factors, though identified, lack unanimous recognition amongst researchers. For example, the majority of papers describe the risk factors for left-sided anastomosis, the principal risk being male sex and lower anastomosis, while little data exists defining AL risk factors in a right colectomy. Also, gut microbioma is gaining an emerging role as potential risk factor for leakage. | Antonio Sciuto Giovanni Merola Giovanni D De Palma Maurizio Sodo Felice Pirozzi Umberto M Bracale Umberto Bracale | 2018 | World Journal of Gastroenterology2018，24，21： | 48 |
| 3 | Long-term albumin infusion improves survival in patients with cirrhosis and ascites: An unblinded randomized trial显示文摘瞄准:在幸存上调查长期的白朊管理的效果,腹水的复发和另外的复杂并发症的发作。方法:为第一发作的腹水招收的 100 个连续病人被使随机化加人的白朊收到利尿剂第一年和 25 g 里的 25 g/wk 每二 wk 此后(组 1 ) 或利尿剂独自一个(组 2 ) 。没有肝移植,主要端点是幸存。第二等的端点是腹水的复发和另外的复杂并发症的出现。结果:中部的后续是 84 (2-120 ) 瞬间。对待白朊的病人有显著地更大的累积幸存率(Breslow test=7.05, P=0.0078 ) 并且腹水复发的更低的概率(51% 对 94% , P<0.0001 ) 。长期的白朊注入导致了 16 瞬间的幸存的吝啬的增加。结论:在第一发作的腹水以后的长期的白朊管理显著地改进病人的幸存并且减少腹水复发的风险。 | Roberto Giulio Romanelli Giorgio La Villa Giuseppe Barletta Francesco Vizzutti Fabio Lanini Umberto Arena Vieri Boddi Roberto Tarquini Pietro Pantaleo Paolo Gentilini Giacomo Laffi | 2006 | World Journal of Gastroenterology2006，12，9： | 22 |
| 4 | 儿童急性呼吸窘迫综合征的治疗进展(英文)显示文摘急性呼吸窘迫综合征(ARDS)是一种具有复杂病理和发病机制的异质性综合征,目前仍没有一个明确和有效的治疗对策。根据低氧血症程度,ARDS分成三类:轻度(200mmHg〈氧合指数≤300mmHg)、中度(100mmHg〈氧合指数≤200mmHg)、严重(氧合指数≤100mmHg)。治疗ARDS的基础是正确的重症监护治疗。早期管理可以改善预后,避免副作用和并发症,并提高存活率。治疗诱因(如败血症、肺炎),最大限度地减少多器官功能衰竭(MOF)、功能障碍和呼吸机相关性肺损伤(VILI)的风险在治疗过程中是至关重要的。 | Giuseppe A. Marraro Chengshui Chen Maria Antonella Piga Yan Qian Claudio Spada Umberto Genovese1 | 2014 | 中国当代儿科杂志2014，16，5： | 19 |
| 5 | Resective surgery for liver tumor: a multivariate analysis of causes and risk factors linked to postoperative complications显示文摘BACKGROUND: In spite of accurate selection of patients eligible for resection, and although advances in surgical techniques and perioperative management have greatly contributed to reducing the rate of perioperative deaths, stress must be placed on reducing the postoperative complication rates reported to be still as high as 50%. This study was designed to analyze the causes and foreseeable risk factors linked to postoperative morbidity on the grounds of data derived from a single-center surgical population. METHODS: From September 1989 to March 2005, 287 consecutive patients, affected either with HCC or liver metastasis, had liver resection at our department. Among the HCC series we recorded 98 patients (73.2%) in Child- Pugh class A, 32 (23.8%) in class B and 4 in class C (3%). In 104 colorectal metastases, 71% were due to colon cancer, 25% rectal, 3% sigmoid, and 1% anorectal. In 49 non-colorectal metastases, 22.4% were derived from breast cancer, 63.2% gastrointestinal tumors (excluding colon) and 14.4% other cancers. We performed 80 wedge resections, 77 bisegmentectomies and/or left lobectomies, 74 segmentectomies, 22 major hepatectomies, 20 left hepatectomies, and 14 trisegmentectomies. RESULTS: The in-hospital mortality rate in this series was 4.5%, and the morbidity rate was 47.7%, because of pleural effusion (30%), hepatic abscess (25%), hepatic insufficiency (19%), ascites (10%), hemoperitoneum (10%), or biliary fistula (6%). The variables associated with the technical aspects of the surgical procedure thatwere responsible for the complications were: a Pringle maneuver length more than 20 minutes (P=0.001); the type of liver resection procedure, including major hepatectomy (P=0.02), left hepatectomy (P=0.04), trisegmentectomy (P=0.04), bisegmentectomy and/or left lobectomy (P=0,04); and a blood transfusion of more than 600 ml (P=0.04). CONCLUSION: The evaluation of causes and foreseeable risk factors linked to postoperative morbidity during the planning of surgical treatment should play the same role as other factors weighed in the selection of patients eligible for liver resection. | Enrico Benzoni Dario Lorenzin Umberto Baccarani Gian Luigi Adani Alessandro Favero Alessandro Cojutti Fabrizio Bresadola Alessandro Uzzau | 2006 | Hepatobiliary & Pancreatic Diseases International2006，5，4： | 17 |
| 6 | Perioperative thrombotic complications in liver transplantation显示文摘Although the perioperative bleeding complications and the major side effects of blood transfusion have always been the primary concern in liver transplantation(OLT),the possible cohesion of an underestimated intrinsic hypercoagulative state during and after the transplant procedure may pose a major threat to both patient and graft survival.Thromboembolism during OLT is characterized not only by a complex aetiology,but also by unpredictable onset and evolution of the disease.The initiation of a procoagulant process may be triggered by various factors,such as inflammation,venous stasis,ischemia-reperfusion injury,vascular clamping,anatomical and technical abnormalities,genetic factors,deficiency of profibrinolytic activity,and platelet activation.The involvement of the arterial system,intracardiac thrombosis,pulmonary emboli,portal vein thrombosis,and deep vein thrombosis,are among the most serious thrombotic events in the perioperative period.The rapid detection of occlusive vascular events is of paramount importance as it heavily influences the prognosis,particularly when these events occur intraoperatively or early after OLT.Regardless of the lack of studies and guidelines on anticoagulant prophylaxis in this setting,many institutions recommend such an approach especially in the subset of patients at high risk.However,the decision of when,how and in what doses to use the various chemical anticoagulants is still a difficult task,since there is no common consensus,even for highrisk cases.The risk of postoperative thromboembolism causing severe hemodynamic events,or even loss of graft function,must be weighed and compared with the risk of an important bleeding.In this article we briefly review the risk factors and the possible predictors of major thrombotic complications occurringin the perioperative period,as well as their incidence and clinical features.Moreover,the indications to pharmacological prophylaxis and the current treatment strategies are also summarized. | Paolo Feltracco Stefania Barbieri Umberto Cillo Giacomo Zanus Marco Senzolo Carlo Ori | 2015 | World Journal of Gastroenterology2015，21，26： | 13 |
| 7 | Role of blood AFP mRNA and tumor grade in the preoperative prognostic evaluation of patients with hepatoceiluiar carcinoma显示文摘AIM: To explore the potential prognostic role of preoperative tumor grade and blood AFP mRNA in a cohort of patients with hepatocellular carcinoma (HCC)eligible for radical therapies according to a well-defined treatment algorithm not including nodule size and number as absolute selection criteria.METHODS: Fifty patients with a diagnosis of HCC were prospectively enrolled in the study. Inclusion criteria were: (1) histological assessment of tumor grade by means of percutaneous biopsies; (2) determination of AFP mRNA status in the blood; (3) patient's eligibility for radical therapies.RESULTS: At preoperative evaluation, 54% of the study group had a well-differentiated HCC, 42% had AFP mRNA in the blood, 40% had a tumor larger than 5 cm and 56% had more than one nodule. Surgery (resection or liver transplantation) was performed in 29 patients,while 21 had percutaneous ablation procedures. After a median follow-up of 28 mo, 12-, 24-, and 36-mo survival rates were 78%, 58%, and 51%, respectively. Surgical therapy, performance status and three tumor-related variables (AFP mRNA, HCC grade and gross vascular invasion) resulted as significant survival predictors at univariate analysis. Nodule size and number did not perform as significant prognosticators. Multivariate study selected only surgical therapy and a biologically early HCC profile (AFP mRNA negative and well-differentiated tumor without gross vascular invasion) as independent survival variables.CONCLUSION: The preoperative determination of tumor grade and blood AFP mRNA status may potentially refine the prognostic evaluation of HCC patients and improve the selection process for radical therapies. | Umberto Cillo Alessandro Vitale Filippo Navaglia Daniela Basso Umberto Montin Marco Bassanello Francesco D'Amico Francesco Antonio Ciarleglio Alberto Brolese Giacomo Zanus Vito De Pascale Mario Plebani Davide Francesco D'Amico | 2005 | World Journal of Gastroenterology2005，11，44： | 12 |
| 8 | More anxious than depressed:prevalence and correlates in a 15-nation study of anxiety disorders in people with type 2 diabetes mellitus显示文摘Background Anxiety disorder, one of the highly disabling, prevalent and common mental disorders, is known to be more prevalent in persons with type 2 diabetes mellitus (T2DM) than the general population, and the comorbid presence of anxiety disorders is known to have an impact on the diabetes outcome and the quality of life. However, the information on the type of anxiety disorder and its prevalence in persons with T2DM is limited. Aims To assess the prevalence and correlates of anxiety disorder in people with type 2 diabetes in different countries. Methods People aged 18-65 years with diabetes and treated in outpatient settings were recruited in 15 countries and underwent a psychiatric interview with the Mini-International Neuropsychiatric Interview. Demographic and medical record data were collected. Results A total of 3170 people with type 2 diabetes (56.2% women;with mean (SD) duration of diabetes 10.01 (7.0) years) participated. The overall prevalence of anxiety disorders in type 2 diabetic persons was 18%;however, 2.8% of the study population had more than one type of anxiety disorder. The most prevalent anxiety disorders were generalised anxiety disorder (8.1%) and panic disorder (5.1%). Female gender, presence of diabetic complications, longer duration of diabetes and poorer glycaemic control (HbA1c levels) were significantly associated with comorbid anxiety disorder. A higher prevalence of anxiety disorders was observed in Ukraine, Saudi Arabia and Argentina with a lower prevalence in Bangladesh and India. Conclusions Our international study shows that people with type 2 diabetes have a high prevalence of anxiety disorders, especially women, those with diabetic complications, those with a longer duration of diabetes and poorer glycaemic control. Early identification and appropriate timely care of psychiatric problems of people with type 2 diabetes is warranted. | Santosh K Chaturvedi Shayanth Manche Gowda Helal Uddin Ahmed Fahad D Alosaimi Nicola Andreone Alexey Bobrov Viola Bulgari Giuseppe Carra Gianluca Castelnuovo Giovanni de Girolamo Tomasz Gondek Nikola Jovanovic Thummala Kamala Andrzej Ki Nebojsa Lalic Dusica Lecic-Tosevski Fareed Minhas Victoria Mutiso David Ndetei Golam Rabbani Suntibenchakul Somruk Sathyanarayana Srikanta Rizwan Taj Umberto Valentini Olivera Vukovic Wolfgang Wolwer Larry Cimino Arie Nouwen Cathy Lloyd Norman Sartorius | 2019 | General Psychiatry2019，32，4： | 11 |
| 9 | Modulation of the matrix redox signaling by mitochondrial Ca^(2+)显示文摘Mitochondria sense,shape and integrate signals,and thus function as central players in cellular signal transduction. Ca2+ waves and redox reactions are two such intracellular signals modulated by mitochondria. Mitochondrial Ca2+ transport is of utmost physio-pathological relevance with a strong impact on metabolism and cell fate. Despite its importance,the molecular nature of the proteins involvedin mitochondrial Ca2+ transport has been revealed only recently. Mitochondrial Ca2+ promotes energy metabolism through the activation of matrix dehydrogenases and downstream stimulation of the respiratory chain. These changes also alter the mitochondrial NAD(P)H/NAD(P)+ ratio,but at the same time will increase reactive oxygen species(ROS) production. Reducing equivalents and ROS are having opposite effects on the mitochondrial redox state,which are hard to dissect. With the recent development of genetically encoded mitochondrial-targeted redoxsensitive sensors,real-time monitoring of matrix thiol redox dynamics has become possible. The discoveries of the molecular nature of mitochondrial transporters of Ca2+ combined with the utilization of the novel redox sensors is shedding light on the complex relation between mitochondrial Ca2+ and redox signals and their impact on cell function. In this review,we describe mitochondrial Ca2+ handling,focusing on a number of newly identified proteins involved in mitochondrial Ca2+ uptake and release. We further discuss our recent findings,revealing how mitochondrial Ca2+ influences the matrix redox state. As a result,mitochondrial Ca2+ is able to modulate the many mitochondrial redox-regulated processes linked to normal physiology and disease. | Jaime Santo-Domingo Andreas Wiederkehr Umberto De Marchi | 2015 | World Journal of Biological Chemistry2015，6，4： | 11 |
| 10 | Hepatocellular carcinoma: Where are we?显示文摘Hepatocellular carcinoma(HCC) is the second cause of death due to malignancy in the world, following lung cancer. The geographic distribution of this disease accompanies its principal risk factors: Chronic hepatitis B virus and hepatitis C virus infection, alcoholism, aflatoxin B1 intoxication, liver cirrhosis, and some genetic attributes. Recently, type Ⅱ diabetes has been shown to be a risk factor for HCC together with obesity and metabolic syndrome. Although the risk factors are quite well known and it is possible to diagnose HCC when the tumor is less than 1 cm diameter, it remains elusive at the beginning and treatment is often unsuccessful. Liver transplantation is thus far considered the best treatment for HCC as it cures HCC and the underlying liver disease. Using the Milan criteria, overall survival after liver transplantation for HCC is about 70% after 5 years. Many attempts have been made to go beyond the Milan Criteria and according to recent works reasonably good results have been achieved by using a histochemical marker such as cytokeratine 19 and the so-called 'up to seven criteria' to divide patients into categories according to their risk of relapse. In addition to liver transplantation other therapies have been proposed such as resection, tumor ablation by different means, embolization and chemotherapy. An important step in the treatment of advanced HCC has been the introduction of sorafenib, the first oral, systemic drug that has provided significant improvement in survival. Treatment of HCC patients must be multidisciplinary and by using the different approaches discussed in this review it is possible to offer prolonged survival and quite good and sometimes even excellent quality of life to many patients. | Roberto Mazzanti Umberto Arena Renato Tassi | 2016 | World Journal of Experimental Medicine2016，6，1： | 10 |
| 11 | Combined approach for spontaneous rupture of hepatocellular carcinoma显示文摘Ruptured hepatocellular carcinoma is a rare,emergency occurrence in western countries with high mortality risk.A number of hypotheses have been formulated in order to explain the precise mechanism that leads to hepatocellular carcinoma(HCC) rupture:sub-capsular location,dimensions,portal hypertension,tumour necrosis,local increase of venous pressure due to the outflow reduction caused by neoplastic invasion,and the presence of a previous vascular injury which might predispose to HCC rupture.There is still a debate in the literature concerning the best approach in cases of HCC rupture.Surgery is the first option for treatment of acute abdominal bleeding.However the advent of endovascular treatments widens the range of possible therapies for acute bleeding control and subsequent ablation purposes.We report a case of hemoperitoneum from spontaneous rupture of undiagnosed HCC,that was treated successfully by emergency surgical resection followed by transarterial chemo-embolizationfor local recurrence. | Anna Rossetto Gian Luigi Adani Andrea Risaliti Umberto Baccarani Vittorio Bresadola Dario Lorenzin Giovanni Terrosu | 2010 | World Journal of Hepatology2010，2，1： | 10 |
| 12 | Relationship between adipose tissue dysfunction, vitamin D deficiency and the pathogenesis of non-alcoholic fatty liver disease显示文摘Non-alcoholic fatty liver disease(NAFLD)is the most common chronic liver disease worldwide.Its pathogenesis is complex and not yet fully understood.Over the years many studies have proposed various pathophysiological hypotheses,among which the currently most widely accepted is the'multiple parallel hits'theory.According to this model,lipid accumulation in the hepatocytes and insulin resistance increase the vulnerability of the liver to many factors that act in a coordinated and cooperative manner to promote hepatic injury,inflammation and fibrosis.Among these factors,adipose tissue dysfunction and subsequent chronic low grade inflammation play a crucial role.Recent studies have shown that vitamin D exerts an immune-regulating action on adipose tissue,and the growing wealth of epidemiological data is demonstrating that hypovitaminosis D is associated with both obesity and NAFLD.Furthermore,given the strong association between these conditions,current findings suggest that vitamin D may be involved in the relationship between adipose tissue dysfunction and NAFLD.The purpose of this review is to provide an overview of recent advances in the pathogenesis of NAFLD in relation to adipose tissue dysfunction,and in the pathophysiology linking vitamin D deficiency with NAFLD and adiposity,together with an overview of the evidence available on the clinical utility of vitamin D supplementation in cases of NAFLD. | Flavia A Cimini Ilaria Barchetta Simone Carotti Laura Bertoccini Marco G Baroni Umberto Vespasiani-Gentilucci Maria-Gisella Cavallo Sergio Morini | 2017 | World Journal of Gastroenterology2017，23，19： | 9 |
| 13 | Starring role of toll-like receptor-4 activation in the gutliver axis显示文摘Since the introduction of the term 'gut-liver axis', many studies have focused on the functional links of intestinal microbiota, barrier function and immune responses to liver physiology. Intestinal and extra-intestinal diseases alter microbiota composition and lead to dysbiosis, which aggravates impaired intestinal barrier function via increased lipopolysaccharide translocation. The subsequent increased passage of gut-derived product from the intestinal lumen to the organ wall and bloodstream affects gut motility and liver biology. The activation of the toll-like receptor 4(TLR-4) likely plays a key role in both cases. This review analyzed the most recent literature on the gut-liver axis, with a particular focus on the role of TLR-4 activation. Findings that linked liver disease with dysbiosis are evaluated, and links between dysbiosis and alterations of intestinal permeability and motility are discussed. We also examine the mechanisms of translocated gut bacteria and/or the bacterial product activation of liver inflammation and fibrogenesis via activity on different hepatic cell types. | Simone Carotti Michele Pier Luca Guarino Umberto Vespasiani-Gentilucci Sergio Morini | 2015 | World Journal of Gastrointestinal Pathophysiology2015，6，4： | 8 |
| 14 | 经腹机器人辅助腹腔镜肾部分切除术治疗T2期肾肿瘤的国际多中心临床研究显示文摘目的通过国际多中心研究探讨临床T2期肾肿瘤行经腹机器人辅助腹腔镜肾部分切除术的安全性及有效性。方法回顾性分析2012年1月至2017年12月国际19家泌尿中心378例临床T2期肾肿瘤行经腹机器人肾部分切除术和经腹机器人根治性肾切除术患者的临床资料。根据手术方式不同,分为部分切除组和根治组。部分切除组159例,男118例,女41例;年龄(59.3±13.2)岁,体重指数(28.7±5.4) kg/m^2,术前GFR (77.3±22.1)ml/min;肿瘤位于左侧72例,右侧87例;肿瘤直径(83±16)mm;R.E.N.A.L.评分(8.6±2.2)分。根治组219例,男156例,女63例;年龄(62.0±12.9)岁,体重指数(28.7±6.1) kg/m^2,术前GFR (71.4±20.3)ml/min;肿瘤位于左侧112例,右侧105例,双侧2例;肿瘤直径(92±25)mm;R.E.N.A.L.评分(9.7±1.5)分。两组患者性别、体重指数、肿瘤位置的差异均无统计学意义(P〉0.05)。部分切除组患者年龄、肿瘤直径、R.E.N.A.L.评分均低于根治组(P〈0.05),术前GFR优于根治组(P=0.012)。比较两组围手术期资料、肿瘤病理类型、随访时间、复发时间及术后GFR等。结果378例手术均顺利完成。部分切除组手术时间中位值150 min(65-353 min),短于根治组[180 min(85-361 min),P〈0.001],术中出血量中位值150 ml(40-3 000 ml),多于根治组[100 ml (10-1 100 ml),P〈0.001]。术中并发症发生率部分切除组为5.7%(9/159),根治组为3.2%(7/219),两组差异无统计学意义(P=0.240)。部分切除组术后并发症发生率高于根治组[19.5%(31/159)与10.5%(23/219),P=0.014],但≥3级并发症发生率的差异无统计学意义[4.4%(7/159)与2.3%(5/219),P=0.246]。部分切除组无复发生存率高于根治组[91.4%(117/128)与81.9%(167/204),P=0.013]。部分切除组术后GFR降低值16.9 ml/min(10.4-84.7 ml/min)明显少于根治组29.0 ml/min(14.0-54.0 ml/min),肾部分切除术更利于术后肾功能的保护(P〈0.001)。结论临床T2期肾肿瘤行机器人肾部分切除术可获得有效的肿瘤控制率,同时可以更好地保护肾功能,可作为临床T2期肾肿瘤有效的手术方式。 | 过菲 张超 王富博 王林辉 杨庆 叶华茂 吕晨 肖成武 汪洋 Giuseppe Simone Ithaar Derweesh Andrea Minervini Daniel Eun Francesco Porpiglia Sisto Perdona James Porter Matteo Ferro Alexandre Mottrie Robert Uzzo Luigi Schips Wesley White Ken Jacobsohn Prokar Dasgupta Riccardo Autorino Clayton Lau Chandru Sundaram Umberto Capitanio 孙颖浩 杨波 | 2018 | 中华泌尿外科杂志2018，39，6： | 8 |
| 15 | Prediction of hepatocellular carcinoma biological behaviorin patient selection for liver transplantation显示文摘Morphological criteria have always been considered the benchmark for selecting hepatocellular carcinoma(HCC)patients for liver transplantation(LT).These criteria,which are often inappropriate to express the tumor’s biological behavior and aggressiveness,offer only a static view of the disease burden and are frequently unable to correctly stratify the tumor recurrence risk after LT.Alpha-fetoprotein(AFP)and its progression as well as AFP-m RNA,AFP-L3%,des-γ-carboxyprothrombin,inflammatory markers and other serological tests appear to be correlated with post-transplant outcomes.Several other markers for patient selection including functional imaging studies such as18F-FDG-PET imaging,histological evaluation of tumor grade,tissue-specific biomarkers,and molecular signatures have been outlined in the literature.HCC growth rate and response to pre-transplant therapies can further contribute to the transplant evaluation process of HCC patients.While AFP,its progression,and HCC response to pretransplant therapy have already been used as a part of an integrated prognostic model for selecting patients,the utility of other markers in the transplant setting is still under investigation.This article intends to review the data in the literature concerning predictors that could be included in an integrated LT selection model and to evaluate the importance of biological aggressiveness in the evaluation process of these patients. | Umberto Cillo Tommaso Giuliani Marina Polacco Luz Maria Herrero Manley Gino Crivellari Alessandro Vitale | 2016 | World Journal of Gastroenterology2016，22，1： | 7 |
| 16 | Transplant benefit for patients with hepatocellular carcinoma显示文摘Although liver transplantation is theoretically the best treatment for hepatocellular carcinoma(HCC),it is limited by the realities of perioperative complications,and the shortage of donor organs.Furthermore,in many cases there are available alternative treatments such as resection or locoregional therapy.Deciding upon the best option for a patient with HCC is complicated,involving numerous ethical principles including:urgency,utility,intention-to-treat survival,transplant benefit,harm to candidates on waiting list,and harm to living donors.The potential contrast between different principles is particularly relevant for patients with HCC for several reasons:(1)HCC candidates to liver transplantation are increasing;(2)the great prognostic heterogeneity within the HCC population;(3)in HCC patients tumor progression before liver transplantation may significantly impair post transplant outcome;and(4)effective alternative therapies are often available for HCC candidates to liver transplantation.In this paper we suggest that allocating organs by transplant benefit could help balance these competing principles,and also introduce equity between patients with HCC and nonmalignant liver disease.We also propose a triangular equipoise model to help decide between deceased donor liver transplantation,living donor liver transplantation,or alternative therapies. | Alessandro Vitale Michael Volk Umberto Cillo | 2013 | World Journal of Gastroenterology2013，19，48： | 6 |
| 17 | Invasive fungal infection before and after liver transplantation显示文摘Invasive infections are a major complication before liver transplantation(LT)and in the early phase after surgery.There has been an increasing prevalence of invasive fungal disease(IFD),especially among the sickest patients with decompensated cirrhosis and acute-on-chronic liver failure,who suffer from a profound state of immune dysfunction and receive intensive care management.In such patients,who are listed for LT,development of an IFD often worsens hepatic and extra-hepatic organ dysfunction,requiring a careful evaluation before surgery.In the post-transplant setting,the burden of IFD has been reduced after the clinical advent of antifungal prophylaxis,even if several major issues still remain,such as duration,target population and drug type(s).Nevertheless,the development of IFD in the early phase after surgery significantly impairs graft and patient survival.This review outlines presentation,prophylactic and therapeutic strategies,and outcomes of IFD in LT candidates and recipients,providing specific considerations for clinical practice. | Alberto Ferrarese Annamaria Cattelan Umberto Cillo Enrico Gringeri Francesco Paolo Russo Giacomo Germani Martina Gambato Patrizia Burra Marco Senzolo | 2020 | World Journal of Gastroenterology2020，26，47： | 6 |
| 18 | Covert hepatic encephalopathy: Agreement and predictive validity of different indices显示文摘AIM:To investigate the agreement and prognosticvalue of different measures of covert hepatic encephalopathy(CHE).METHODS:One-hundred-and-thirty-two cirrhotic outpatients underwent electroencephalography(EEG),paper-and-pencil psychometry(PHES)and critical flicker frequency,scored on the original/modified(CFFo/CFFm)thresholds.Eighty-four patients underwent Dopplerultrasound to diagnose/exclude portal-systemic shunt.Seventy-nine were followed-up for 11±7 mo in relation to the occurrence of hepatic encephalopathy(HE)-related hospitalisations.RESULTS:On the day of study,36%had gradeⅠHE,42%abnormal EEG,33%abnormal PHES and 31/21%abnormal CFFo/CFFm.Significant associations were observed between combinations of test abnormalities;however,agreement was poor(Cohen’sκ<0.4).The prevalence of EEG,PHES and CFFo/CFFm abnormalities was significantly higher in patients with gradeⅠovert HE.The prevalence of EEG and CFFm abnormalities was higher in patients with shunt.The prevalence of EEG abnormalities was significantly higher in patients with a history of HE.During follow-up,10 patients died,10were transplanted and 29 had HE-related hospitalisations.GradeⅠHE(P=0.004),abnormal EEG(P=0.008)and abnormal PHES(P=0.04)at baseline all predicted the subsequent occurrence of HE;CFF did not.CONCLUSION:CHE diagnosis probably requires a combination of clinical,neurophysiological and neuropsychological indices. | Sara Montagnese Esmeralda Balistreri Sami Schiff Michele De Rui Paolo Angeli Giacomo Zanus Umberto Cillo Giancarlo Bombonato Massimo Bolognesi David Sacerdoti Angelo Gatta Carlo Merkel Piero Amodio | 2014 | World Journal of Gastroenterology2014，20，42： | 6 |
| 19 | Application of a Robust Model Reference Adaptive Control Algorithm to a Nonlinear Automotive Actuator显示文摘Model reference adaptive control is a viable control method to impose the demanded dynamics on plants whose parameters are affected by large uncertainty. In this paper, we show by means of experiments that robust adaptive methods can effectively face nonlinearities that are common to many automotive electromechanical devices. We consider here, as a representative case study, the control of a strongly nonlinear automotive actuator. The experimental results confirm the effectiveness of the method to cope with unmodeled nonlinear terms and unknown parameters. In addition, the engineering performance indexes computed on experimental data clearly show that the robust adaptive strategy provides better performance compared with those given by a classical model-based control solution with fixed gains. | Alessandro di Gaeta Umberto Montanaro | 2014 | International Journal of Automation and computing2014，11，4： | 5 |
| 20 | Hepatitis C virus and metabolic disorder interactions towards liver damage and atherosclerosis显示文摘Hepatitis C virus(HCV)is one of the main causes of liver disease worldwide,and alterations of glucose metabolism have reached pandemic proportions in western countries.However,the frequent coexistence between these two conditions is more than simply coincidental,since HCV can induce insulin resistance through several mechanisms.Indeed,the virus interferes with insulin signaling both directly and indirectly,inducing the production of pro-inflammatory cytokines.Furthermore,the entire viral life cycle has strict interconnections with lipid metabolism,and HCV is responsible for a'viral'steatosis which is frequently superimposed to a'metabolic'one.Several evidences suggest that HCV-induced metabolic disorders contribute both to the evolution of liver fibrosis and,likely,to the progression of the other disorders which are typically associated with altered metabolism,in particular atherosclerosis.In the present review,we will examine in depth the links between HCV infection and insulin resistance,liver steatosis and diabetes,and analyze the impact of these interactions on the progression of liver fibrosis and atherosclerosis.Special attention will be focused on the highly debated topic of the relationship between HCV infection and cardiovascular disease.The available clinical literature on this item will be broadly reviewed and all the mechanisms possibly implied will be discussed. | Umberto Vespasiani-Gentilucci Paolo Gallo Antonio De Vincentis Giovanni Galati Antonio Picardi | 2014 | World Journal of Gastroenterology2014，20，11： | 5 |
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