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71.
Giuseppe d'Ambrosio Laura del Prete Chiara Grimaldi Arianna Bertocchini Cristina Lo Zupone Lidia Monti Jean de Ville de Goyet 《Journal of pediatric surgery》2014
Purpose
Malignant tumors of the common bile duct or of the pancreas head are uncommon in childhood [Perez EA, Gutierrez JC, Koniaris LG, Neville HL, Thompson WR, Sola JE. Malignant pancreatic tumors: incidence and outcome in 58 pediatric patients. J Pediatr Surg. 2009; Jan; 44 (1): 197–203]. With radical surgery being the standard cure for nonmetastatic diseases, pancreaticoduodenectomy (PD) is the best choice when the tumor is localized in the head of the pancreas, or in the lower portion of the common bile duct. The purpose of the present study is to describe five consecutive children managed by PD, and reviewing the particular aspects and results of this rare procedure in children.Methods
Between 2007 and 2010, five patients (median age: 7 years) underwent PD for nonmetastatic malignant tumors. In two cases, PD was performed en bloc with a right hepatectomy in order to achieve the radical resection of a recurrent biliary sarcoma. Four patients benefited from a “pylorus-preserving” PD procedure. In two patients, resection of the portal vein and vascular reconstruction was performed, and in one case, an extended resection of the biliary ductal system was necessary.Results
All resection margins were clear. The postoperative course was uneventful, with no pancreatic or biliary leakage in all of the patients. Oral refeeding was achieved by the eighth postoperative day. In two cases, a late revision of pancreatic–jejunal anastomosis was performed because of mild steatorrea and a suspected anastomotic stricture. Two of the patients, who were subsequently operated on second hand, for biliary sarcoma, died from the recurrence; while three of the others, with pancreatic malignancies, are alive and well, with a good functional outcome.Conclusions
Surgical resection is the treatment of choice for tumors of the pancreatic head area. In the absence of regional or metastatic extension, the radicality of primary intervention is associated with favorable outcomes. Good functionality results were observed after the PD was limited to the head of the pancreas and subject to pylorus-preserving techniques. 相似文献72.
Marta Radaelli Arianna Merlini Raffaella Greco Francesca Sangalli Giancarlo Comi Fabio Ciceri Gianvito Martino 《Current neurology and neuroscience reports》2014,14(9):1-13
Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system and represents one of the leading causes of neurologic disability in young adults. Current treatments for MS have shown limited efficacy in patients with either a progressive or an aggressive disease course. Hematopoietic stem cell transplantation (HSCT) has been proposed to control or even cure refractory cases of MS. Indeed, HSCT is able to temporarily eradicate the autoreactive cells and to reset the aberrant immune response to self-antigens. In the last decade, owing to the growing experience in selecting the most appropriate patients to transplant and the recent advances in chemotherapeutic and support regimens, the transplant-related mortality of autologous HSCT in MS patients dropped down to 1,3 % and the progression-free survival ranges from 47 % to 100 %. Altogether, these data support autologous HSCT as a possible second-line therapy for refractory MS. 相似文献
73.
Monia Marchetti Arianna Ghirardi Arianna Masciulli Alessandra Carobbio Francesca Palandri Nicola Vianelli Elena Rossi Silvia Betti Ambra Di Veroli Alessandra Iurlo Daniele Cattaneo Guido Finazzi Massimiliano Bonifacio Luigi Scaffidi Andrea Patriarca Elisa Rumi Ilaria Carola Casetti Clemency Stephenson Paola Guglielmelli Elena Maria Elli Miroslava Palova Davide Rapezzi Daniel Erez Montse Gomez Kai Wille Manuel Perez-Encinas Francesca Lunghi Anna Angona Maria Laura Fox Eloise Beggiato Giulia Benevolo Giuseppe Carli Rossella Cacciola Mary Frances McMullin Alessia Tieghi Valle Recasens Susanne Isfort Fabrizio Pane Valerio De Stefano Martin Griesshammer Alberto Alvarez-Larran Alessandro Maria Vannucchi Alessandro Rambaldi Tiziano Barbui 《American journal of hematology》2020,95(3):295-301
One out of ten patients with Philadelphia-negative myeloproliferative neoplasms (MPN) develop a second cancer (SC): in such patients we aimed at assessing the survival impact of SC itself and of MPN-specific therapies. Data were therefore extracted from an international nested case-control study, recruiting 798 patients with SC diagnosed concurrently or after the MPN. Overall, 2995 person-years (PYs) were accumulated and mortality rate (MR) since SC diagnosis was 5.9 (5.1-6.9) deaths for every 100 PYs. A “poor prognosis” SC (stomach, esophagus, liver, pancreas, lung, ovary, head-and-neck or nervous system, osteosarcomas, multiple myeloma, aggressive lymphoma, acute leukemia) was reported in 26.3% of the patients and was the cause of death in 65% of them (MR 11.0/100 PYs). In contrast, patients with a “non-poor prognosis” SC (NPPSC) incurred a MR of 4.6/100 PYs: 31% of the deaths were attributed to SC and 15% to MPN evolution. At multivariable analysis, death after SC diagnosis was independently predicted (HR and 95% CI) by patient age greater than 70 years (2.68; 1.88-3.81), the SC prognostic group (2.57; 1.86-3.55), SC relapse (1.53; 10.6-2.21), MPN evolution (2.72; 1.84-4.02), anemia at SC diagnosis (2.32; 1.49-3.59), exposure to hydroxyurea (1.89; 1.26-2.85) and to ruxolitinib (3.63; 1.97-6.71). Aspirin was protective for patients with a NPPSC (0.60; 0.38-0.95). In conclusion, SC is a relevant cause of death competing with MPN evolution. Prospective data are awaited to confirm the role of cytoreductive and anti-platelet drugs in modulating patient survival after the occurrence of a SC. 相似文献
74.
75.
Alessio Mazzoni Anna Vanni Michele Spinicci Giulia Lamacchia Seble Tekle Kiros Arianna Rocca Manuela Capone Nicoletta Di Lauria Lorenzo Salvati Alberto Carnasciali Elisabetta Mantengoli Parham Farahvachi Lorenzo Zammarchi Filippo Lagi Maria Grazia Colao Francesco Liotta Lorenzo Cosmi Laura Maggi Alessandro Bartoloni Gian Maria Rossolini Francesco Annunziato 《The Journal of clinical investigation》2022,132(6)
BACKGROUNDImmunization against SARS-CoV-2, the causative agent of COVID-19, occurs via natural infection or vaccination. However, it is currently unknown how long infection- or vaccination-induced immunological memory will last.METHODSWe performed a longitudinal evaluation of immunological memory to SARS-CoV-2 up to 1 year after infection and following mRNA vaccination in naive individuals and individuals recovered from COVID-19 infection.RESULTSWe found that memory cells are still detectable 8 months after vaccination, while antibody levels decline significantly, especially in naive individuals. We also found that a booster injection is efficacious in reactivating immunological memory to spike protein in naive individuals, whereas it was ineffective in previously SARS-CoV-2–infected individuals. Finally, we observed a similar kinetics of decay of humoral and cellular immunity to SARS-CoV-2 up to 1 year following natural infection in a cohort of unvaccinated individuals.CONCLUSIONShort-term persistence of humoral immunity, together with the reduced neutralization capacity versus the currently prevailing SARS-CoV-2 variants, may account for reinfections and breakthrough infections. Long-lived memory B and CD4+ T cells may protect from severe disease development. In naive individuals, a booster dose restored optimal anti-spike immunity, whereas the needs for vaccinated individuals who have recovered from COVID-19 have yet to be defined.FUNDINGThis study was supported by funds to the Department of Experimental and Clinical Medicine, University of Florence (Project Excellence Departments 2018–2022), the University of Florence (project RICTD2122), the Italian Ministry of Health (COVID-2020-12371849), and the region of Tuscany (TagSARS CoV 2). 相似文献
76.
77.
Pacchiarotti A Mohamed MA Micara G Linari A Tranquilli D Espinola SB Aragona C 《Journal of assisted reproduction and genetics》2007,24(10):459-462
Purpose To evaluate the effect of the hyperhomocysteinemia on pregnancy rate, implantation rate and abortion rate after IVF.
Method Data from a total of 48 infertile couples with hyperhomocysteinemia were prospectively collected for this study. All patients
underwent a standard down regulation protocol for ovarian stimulation. Oocytes recovery was performed at 36 h after hCG administration.
Embryo transfer took place at 48 h after insemination. The patients were matched in two groups that received or did not receive
therapy (group A and B respectively) to normalize homocysteine plasma level.
Results Pregnancy rate, implantation rate and abortion rate varied significantly (p ≤ 0.05) between the two groups. The number and quality of embryos transferred did not differ between the groups.
Conclusion The results suggest that hyperhomocysteinemia could affect IVF outcome 相似文献
78.
79.
Flavio Labriola Caterina Marcato Chiara Zarbo Ludovica Betti Arianna Catelli Maria Chiara Valerii Enzo Spisni Patrizia Alvisi 《Nutrients》2022,14(3)
Diet is a matter of interest in the pathogenesis and management of Crohn’s Disease (CD). Little is known about CD children’s dietary habits. Our aim was assessing the quality and the amount of nutrient intake in a group of CD pediatric patients. Data were compared with those of healthy subjects (HS). In total, 20 patients (13 males) and 48 HS (24 males) aged 4–18 years were provided with a food diary to fill out for one week. Winfood software performed the bromatological analysis, providing data about intakes of proteins and amino acids, fatty acids, carbohydrates, cholesterol, fibers, minerals, vitamins, and polyphenols. Estimates of the antioxidant activity of foods and of the dietetic protein load were also calculated. The diet of CD patients was poorer in fibers, polyphenols, vitamin A, beta-carotene, and fatty acids, and richer in animal proteins, vitamin B12, and niacin. PRAL was higher in CD patients’ diets, while ORAC was higher in HS. No significant differences were observed in carbohydrate and other macro- and micronutrient consumptions. CD dietary habits seem to reflect the so-called Western diet, possibly involved in CD pathogenesis. Furthermore, analysis of dietary habits allows for prevention of nutritional deficiencies and timely correction through education and supplementation. 相似文献