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排序方式: 共有447条查询结果,搜索用时 15 毫秒
91.
92.
Niccol Furbetta Annalisa Comandatore Desire Gianardi Matteo Palmeri Gregorio Di Franco Simone Guadagni Giovanni Caprili Matteo Bianchini Lorenzo Maria Fatucchi Martina Picchi Luca Bastiani Giandomenico Biancofiore Giulio Di Candio Luca Morelli 《Nutrients》2021,13(6)
Total pancreatectomy (TP) is a highly invasive procedure often performed in patients affected by anorexia, malabsorption, cachexia, and malnutrition, which are risk factors for bad surgical outcome and even may cause enhanced toxicity to chemo-radiotherapy. The role of nutritional therapies and the association between nutritional aspects and the outcome of patients who have undergone TP is described in some studies. The aim of this comprehensive review is to summarize the available recent evidence about the influence of nutritional factors in TP. Preoperative nutritional and metabolic assessment, but also intra-operative and post-operative nutritional therapies and their consequences, are analyzed in order to identify the aspects that can influence the outcome of patients undergoing TP. The results of this review show that preoperative nutritional status, sarcopenia, BMI and serum albumin are prognostic factors both in TP for pancreatic cancer to support chemotherapy, prevent recurrence and prolong survival, and in TP with islet auto-transplantation for chronic pancreatitis to improve postoperative glycemic control and obtain better outcomes. When it is possible, enteral nutrition is always preferable to parenteral nutrition, with the aim to prevent or reduce cachexia. Nowadays, the nutritional consequences of TP, including diabetes control, are improved and become more manageable. 相似文献
93.
Karol Polom Christine Böger Elizabeth Smyth Daniele Marrelli Hans-Michael Behrens Luigi Marano Thomas Becker Florian Lordick Christoph Röcken Franco Roviello 《European journal of surgical oncology》2018,44(5):626-631
Background
Current guidelines recommend that metastatic gastric cancer should not be treated with surgery unless this is required for symptom control. We hypothesized that patients with mismatch repair deficiency (MMRd) gastric cancer and metastatic disease detected at the timepoint of surgical resection would have superior survival compared to patients with MMRd cancers in the same setting.Methods
Clinicopathological details and survival data were collected from prospective databases at two large European centers on patients who had undergone surgery and were diagnosed with synchronous stage IV gastric cancer (distant lymph nodes, positive peritoneal cytology, peritoneal, and distant metastases) at the timepoint of surgery. Resection specimens were tested for the presence of microsatellite instability using a standard 5 mononucleotide repeat panel.Results
One hundred and seventy six patients with resected stage IV gastric cancer were identified. 14/176 (8.0%) had MSI-H (high) disease. There was no significant difference between the clinical and pathological characteristics of MSI and microsatellite stable (MSS) patients. No differences in the type of metastases were observed between MSI and MSS groups. Patients who were MSI-H had superior OS compared to MSS patients (median OS 15.9 vs. 8 months, p = 0.023). However, in Cox regression multivariate analysis only liver and peritoneal metastases were independent predictors of survival.Conclusions
Surgically treated patients with MSI-H stage IV gastric cancer have a better survival than patients with MSS gastric cancer. Further analysis of the role of surgery in MSI stage IV GC is required. 相似文献94.
95.
A R Trapani L Tamburri V Di Giandomenico A De Pascale L Bonomo 《La Radiologia medica》1992,83(6):777-782
The differential diagnosis of peripelvic cysts and hydronephrosis by means of US sometimes presents some problems; in fact, the use of urography to solve a diagnostic doubt is not uncommon. This study was aimed at demonstrating that another US sign, which we have called the "convexity" sign, can be useful in allowing peripelvic cysts to be distinguished from hydronephrosis. Thus, cysts exhibit convex walls and curved outline, whereas in hydronephrosis the walls of the dilated calices are linear. The latter feature is present in all degrees of hydronephrosis, except in severe cases. Forty-nine adult patients, a total of 98 kidneys, were examined with US and urography; 69 kidneys were found to be pathologic: 48 presented with cysts, and 21 with hydronephrosis. In addition to the new sign, the classic signs of peripelvic cysts were also considered, that is the separate areas and the non-visualization of the ureter. The sensitivity of the new sign was 97% and its specificity was 95%. The sensitivity and the specificity of the classic signs were 97% and 95%, respectively for the separated areas, and 100% and 91% for the non-visualization of the ureter. The cumulative sensitivity of the 3 signs was 99%, and their specificity 96%. Our results show how the integrated analysis of the considered signs (especially those with high specificity) is useful for the differential diagnosis, and therefore to avoid the indiscriminate use of urography. 相似文献
96.
97.
Giandomenico Roviello Daniele Lavacchi Lorenzo Antonuzzo Martina Catalano Enrico Mini 《World journal of gastroenterology : WJG》2022,28(15):1503-1507
Colorectal cancer (CRC) is one of the most prevalent cancers and the second leading cause of cancer-related deaths worldwide. The treatment strategy employed in CRC patients is becoming highly dependent on molecular characteristics present at diagnosis and during treatment. Liquid biopsy is an emerging field in the management of this cancer, and its relevance as a potential diagnostic, prognostic, monitoring, and therapeutic tool makes it a viable strategy in the clinical management of CRC patients. Liquid biopsy also has certain limitations, but these limitations seem to be at the reach of near-future technological development. In this letter, we focus on the clinical perspectives of liquid biopsy in CRC with particular regard to the various biomarkers recently identified that have been shown to be potentially useful in multiple aspects of early stage or metastatic CRC. 相似文献
98.
Paolo Morgagni Leonardo Solaini Luca Saragoni Maria Bencivenga Uberto Fumagalli Romario Luigina Graziosi Elisabetta Marino Daniele Marrelli Stefano Rausei Fausto Rosa Emanuela Scarpi Anna Tomezzoli Domenico Tringali Carla Vindigni Giovanni Vittimberga Franco Roviello 《European journal of surgical oncology》2018,44(8):1186-1190
Background
To investigate the role of Kodama PenA subtype in influencing survival in patients with early gastric cancer (EGC).Methods
All patients surgically treated for EGC at 7 Italian centers (Forlì, Varese, Siena, Verona, Milan, Rome and Perugia) belonging to the Italian Research Group for Gastric Cancer (GIRCG) from January 1982 and December 2009 were included.Results
PenA patients were 230 (21.5%) while other types were 839 (78.5%). Nodal metastases were more common in PenA (30.7%) than non-PenA (10.4%) EGCs. Among preoperative variables, only age (OR 1.02; 95% CI 1.00–1.03, p = 0.009) and macrotype III (OR 1.95; 95% CI 1.39–2.75, p = 0.0001) were significantly associated with Pen A type. Survival analysis performed on N0 patients demonstrated that only size >2 cm (HR 1.85; 95% CI 1.12–3.05, p = 0.017) and age (HR 1.06; 95% CI 1.03–1.08, p < 0.0001) were independent poor prognostic factor. Among N+ patients age (HR 1.04; 95% CI 1.00–1.07, p = 0.048), number of positive lymph nodes (HR 1.13; 95% CI 1.05–1.20, p = 0.0002) and PenA (HR 4.23; 95% CI 1.70–10.55, p = 0.002) were significantly correlated with poor prognosis at multivariate analysis.Conclusions
Kodama PenA subtype was the most powerful independent prognostic factor in patients with nodal metastases. Its status should always be investigated in EGCs patients. 相似文献99.
Rebecca Strawbridge Paul McCrone Andrea Ulrichsen Roland Zahn Jonas Eberhard Danuta Wasserman Paolo Brambilla Giandomenico Schiena Ulrich Hegerl Judit Balazs Jose Caldas de Almeida Ana Antunes Spyridon Baltzis Vladmir Carli Vinciane Quoidbach Patrice Boyer Allan H. Young 《European psychiatry》2022,65(1)
BackgroundDespite well-established guidelines for managing major depressive disorder, its extensive disability burden persists. This Value of Treatment mission from the European Brain Council aimed to elucidate the nature and extent of “gaps” between best-practice and current-practice care, specifically to:
- Identify current treatment gaps along the care pathway and determine the extent of these gaps in comparison with the stepped-care model and
- Recommend policies intending to better meet patient needs (i.e., minimize treatment gaps).
100.
Rossella.Giuliani Ivana Antonucci Isabella Torrente Paola Grammatico Giandomenico Palka Liborio Stuppia 《Asian journal of andrology》2010,12(6):819-826
Congenital bilateral absence of vas deferens (CBAVD) is a manifestation of the mildest form of cystic fibrosis (CF) and is characterized by obstructive azoospermia in otherwise healthy patients. Owing to the availability of assisted reproductive technology, CBAVD patients can father children. These fathers are at risk of transmitting a mutated allele of the CF transmembrane conductance regulator (CFTR) gene, responsible for CF, to their offspring. The identification of mutations in both CFTR alleles in CBAVD patients is a crucial requirement for calculating the risk of producing a child with full-blown CF if the female partner is a healthy CF carrier. However, in the majority of CBAVD patients, conventional mutation screening is not able to detect mutations in both CFTR alleles, and this difficulty hampers the execution of correct genetic counselling. To obtain information about the most represented CFTR mutations in CBAVD patients, we analysed 23 CBAVD patients, 15 of whom had a single CFTR mutation after screening for 36 mutations and the 5T allele. The search for the second CFTR mutation in these cases was performed by using a triplex approach: (i) first, a reverse dot-blot analysis was performed to detect mutations with regional impact; (ii) next, multiple ligation-dependent probe amplification assays were conducted to search for large rearrangements; and (iii) finally, denaturing high-performance liquid chromatography was used to search for point mutations in the entire coding region. Using these approaches, the second CFTR mutation was detected in six patients, which increased the final detection rate to 60.8%. 相似文献