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| 1 | Current management strategy of hepatocellular carcinoma显示文摘Hepatocellular carcinoma (HCC) still remains a considerable challenge for surgeons.Surgery,including liver transplantation,is the most important therapeutic approach for patients with this disease.HCC is frequently diagnosed at advanced stages and has a poor prognosis with a high mortality rate even when surgical resection has been considered potentially curative.This brief report summarizes the current status of the management of this malignancy and includes a short description of new pharmacological approaches in HCC treatment. | Bernardino Rampone Beniamino Schiavone Antonio Martino Carmine Viviano Giuseppe Confuorto | 2009 | World Journal of Gastroenterology2009,15,26: | 50 |
| 2 | What about non-alcoholic fatty liver disease as a new criterion to define metabolic syndrome?显示文摘Non-alcoholic fatty liver disease (NAFLD) is currently not a component of the diagnostic criteria for metabolic syndrome (MetS); however, the development of NAFLD has some common mechanisms with the development of MetS, as they share the pathophysiologic basis of insulin resistance. It is also recognized that NAFLD is the hepatic manifestation of MetS. To define MetS, the presence of at least three of the proposed criteria is required, and sometimes it is sufficient to have only one laboratory value, modified by diet or drugs, for the classification of MetS. Ultrasonographically-detected NAFLD (US-NAFLD) is more stable, only changing during the middleto long-term. Although controversies over MetS continue, and considering that abdominal ultrasonography for diagnosing NAFLD has high specificity and guidelines to modify the natural course of NAFLD by diet composition or lifestyle have not yet been established, why should we not introduce US-NAFLD as a new criterion to define MetS? | Giovanni Tarantino Carmine Finelli | 2013 | World Journal of Gastroenterology2013,19,22: | 34 |
| 3 | What is the role of adiponectin in obesity related non-alcoholic fatty liver disease?显示文摘Non-alcoholic fatty liver disease (NAFLD) is recognized as the most common type of chronic liver disease in Western countries.Insulin resistance is a key factor in the pathogenesis of NAFLD,the latter being considered as the hepatic component of insulin resistance or obesity.Adiponectin is the most abundant adipose-specific adipokine.There is evidence that adiponectin decreases hepatic and systematic insulin resistance,and attenuates liver inflammation and fibrosis.Adiponectin generally predicts steatosis grade and the severity of NAFLD;however,to what extent this is a direct effect or related to the presence of more severe insulin resistance or obesity remains to be addressed.Although there is no proven pharmacotherapy for the treatment of NAFLD,recent therapeutic strategies have focused on the indirect upregulation of adiponectin through the administration of various therapeutic agents and/or lifestyle modifications.In this adiponectin-focused review,the pathogenetic role and the potential therapeutic benefits of adiponectin in NAFLD are analyzed systematically. | Carmine Finelli Giovanni Tarantino | 2013 | World Journal of Gastroenterology2013,19,6: | 29 |
| 4 | Follow-up of intestinal metaplasia in the stomach: When, how and why显示文摘Gastric cancer remains the second most frequent cause of cancer-related mortality in the world. Screening programs in some Asian countries are impractical in the majority of other countries worldwide. Therefore, follow-up of precancerous lesions is advisable for secondary gastric cancer prevention. Intestinal metaplasia (IM) is recognized as a precancerous lesion for gastric cancer, increasing the risk by 6-fold. IM is highly prevalent in the general population, being detected in nearly 1 of every 4 patients undergoing upper endoscopy. The IM prevalence rate is significantly higher in patients with Helicobacter pylori (H. pylori) infection, in first-degree relatives of gastric cancer patients, in smokers and it increases with patient age. IM is the 'breaking point' in the gastric carcinogenesis cascade and does not appear to regress following H. pylori eradication, although the cure of infection may slow its progression. Gastric cancer risk is higher in patients with incomplete-type IM, in those with both antral and gastric body involvement, and the risk significantly increases with IM extension over 20% of the gastric mucosa. Scheduled endoscopic control could be cost-effective in IM patients, depending on the yearly incidence of gastric cancer in IM patients, the stage of gastric cancer at diagnosis discovered at surveillance, and the cost of endoscopy. As a pragmatic behavior, yearly endoscopic control would appear justified in all IM patients with at least one of these conditions: (1) IM extension > 20%; (2) the presence of incomplete type IM; (3) first-degree relative of gastric cancer patients; and (4) smokers. In the remaining IM patients, a less intensive (2-3 years) could be proposed. | Angelo Zullo Cesare Hassan Adriana Romiti Michela Giusto Carmine Guerriero Roberto Lorenzetti Salvatore MA Campo Silverio Tomao | 2012 | World Journal of Gastrointestinal Oncology2012,4,3: | 25 |
| 5 | Cryptocurrency trading:a comprehensive survey显示文摘In recent years,the tendency of the number of financial institutions to include crypto-currencies in their portfolios has accelerated.Cryptocurrencies are the first pure digital assets to be included by asset managers.Although they have some commonalities with more traditional assets,they have their own separate nature and their behaviour as an asset is still in the process of being understood.It is therefore important to summarise existing research papers and results on cryptocurrency trading,including available trading platforms,trading signals,trading strategy research and risk management.This paper provides a comprehensive survey of cryptocurrency trading research,by covering 146 research papers on various aspects of cryptocurrency trading(e.g.,cryptocurrency trading systems,bubble and extreme condition,prediction of volatility and return,crypto-assets portfolio construction and crypto-assets,technical trading and others).This paper also analyses datasets,research trends and distribution among research objects(contents/properties)and technologies,concluding with some promising opportunities that remain open in cryptocurrency trading. | Fan Fang Carmine Ventre Michail Basios Leslie Kanthan David Martinez-Rego Fan Wu Lingbo Li | 2022 | Financial Innovation2022,8,1: | 21 |
| 6 | Performance of liver stiffness measurements by transient elastography in chronic hepatitis显示文摘AIM:To compare results of liver stiffness measurements by transient elastography(TE) obtained in our patients population with that used in a recently published meta-analysis.METHODS:This was a single center cross-sectional study.Consecutive patients with chronic viral hepatitis scheduled for liver biopsy at the outpatient ward of our Infectious Diseases Department were enrolled.TE was carried out by using FibroScan(Echosens,Paris,France).Liver biopsy was performed on the same day as TE,as day case procedure.Fibrosis was staged according to the Metavir scoring system.The diagnostic performance of TE was assessed by using receiver operating characteristic(ROC) curves and the area under the ROC curve analysis.RESULTS:Two hundred and fifty-two patients met the inclusion criteria.Six(2%) patients were excluded due to unreliable TE measurements.Thus,246(171 men and 75 women) patients were analyzed.One hundred and ninety-five(79.3%) patients had chronic hepatitis C,41(16.7%) had chronic hepatitis B,and 10(4.0%) were coinfected with human immunodeficiency virus.ROC curve analysis identified optimal cut-off value of TE as high as 6.9 kPa forF ≥ 2;7.9 kPa forF ≥ 3;9.6 kPa for F = 4 in all patients(n = 246),and as high as 6.9 kPa for F ≥ 2;7.3 kPa for F ≥ 3;9.3 kPa for F = 4 in patients with hepatitis C(n = 195).Cut-off values of TE obtained by maximizing only the specificity were as high as 6.9 kPa for F ≥ 2;9.6 kPa for F ≥ 3;12.2 kPa for F = 4 in all patients(n = 246),and as high as 7.0 kPa forF ≥ 2;9.3 kPa forF ≥ 3;12.3 kPa forF = 4 in patients with hepatitis C(n = 195).CONCLUSION:The cut-off values of TE obtained in this single center study are comparable to that obtained in a recently published meta-analysis that included up to 40 studies. | Giovanna Ferraioli Carmine Tinelli Barbara Dal Bello Mabel Zicchetti Raffaella Lissandrin Gaetano Filice Carlo Filice Elisabetta Above Giorgio Barbarini Enrico Brunetti Willy Calderon Marta Di Gregorio Roberto Gulminetti Paolo Lanzarini Serena Ludovisi Laura Maiocchi Antonello Malfitano Giuseppe Michelone Lorenzo Minoli Mario Mondelli Stefano Novati Savino FA Patruno Alessandro Perretti Gianluigi Poma Paolo Sacchi Domenico Zanaboni Marco Zaramella | 2013 | World Journal of Gastroenterology2013,19,1: | 18 |
| 7 | Pathogenesis of hepatic steatosis:The link between hypercortisolism and non-alcoholic fatty liver disease显示文摘Based on the available literature,non alcoholic fatty liver disease or generally speaking,hepatic steatosis,is more frequent among people with diabetes and obesity,and is almost universally present amongst morbidly obese diabetic patients.Non alcoholic fatty liver disease is being increasingly recognized as a common liver condition in the developed world,with non alcoholic steatohepatitis projected to be the leading cause of liver transplantation.Previous data report that only 20%of patients with Cushing’s syndrome have hepatic steatosis.Aiming at clarifying the reasons whereby patients suffering from Cushing’s syndrome-a condition characterized by profound metabolic changes-present low prevalence of hepatic steatosis,the Authors reviewed the current concepts on the link between hypercortisolism and obesity/metabolic syndrome.They hypothesize that this low prevalence of fat accumulation in the liver of patients with Cushing’s syndrome could result from the inhibition of the so-called low-grade chronicinflammation,mainly mediated by Interleukin 6,due to an excess of cortisol,a hormone characterized by an anti-inflammatory effect.The Cushing’s syndrome,speculatively considered as an in vivo model of the hepatic steatosis,could also help clarify the mechanisms of non alcoholic fatty liver disease. | Giovanni Tarantino Carmine Finelli | 2013 | World Journal of Gastroenterology2013,19,40: | 16 |
| 8 | Obesity and kidney disease: hidden consequences of the epidemic显示文摘Obesity has become a worldwide epidemic,and its prevalence has been projected to grow by 40% in the next decade. This increasing prevalence has implications for the risk of diabetes,cardiovascular disease and also for Chronic Kidney Disease. A high body mass index is one of the strongest risk factors for new-onset Chronic Kidney Disease. In individuals affected by obesity, a compensatory hyperfiltration occurs to meet the heightened metabolic demands of the increased body weight. The increase in intraglomerular pressure can damage the kidneys and raise the risk of developing Chronic Kidney Disease in the long-term. The incidence of obesity-related glomerulopathy has increased ten-fold in recent years. Obesity has also been shown to be a risk factor for nephrolithiasis,and for a number of malignancies including kidney cancer. This year the World Kidney Day promotes education on the harmful consequences of obesity and its association with kidney disease,advocating healthy lifestyle and health policy measures that makes preventive behaviors an affordable option. | Csaba P.Kovesdy Susan Furth Carmine Zoccali | 2017 | 肾脏病与透析肾移植杂志2017,26,1: | 14 |
| 9 | Liver-spleen axis: Intersection between immunity, infections and metabolism显示文摘Spleen has been considered a neglected organ so far, even though is strictly linked to liver. The spleen plays an important role in the modulation of the immune system and in the maintenance of peripheral tolerance via the clearance of circulating apoptotic cells, the differentiation and activation of T and B cells and production of antibodies in the white pulp. Moreover, splenic macrophages are able to remove bacteria from the blood and protect from sepsis during systemic infections. We review the spleen function and its assessment in humans starting from the description of spleen diseases, ranging from the congenital asplenia to secondary hyposplenism. From the literature data it is clear that obesity in humans affects different compartments of immune system, even thought there are still few data available on the implicated mechamisms. The intent is to enable clinicians to evaluate the newly recognized role of metabolic and endocrine functions of the spleen with special emphasis to obesity and nonalcoholic fatty liver disease in the context of the available literature.Moreover, understanding the spleen function could be important to develop appropriate prevention strategies in order to counteract the pandemia of obesity. In this direction, we suggest spleen longitudinal diameter at ultrasonography, as simple, cheap and largely available tool, be used as new marker for assessing splenic function, in the context of the so-called liver-spleen axis. | Giovanni Tarantino Antonella Scalera Carmine Finelli | 2013 | World Journal of Gastroenterology2013,19,23: | 13 |
| 10 | Point shear wave elastography method for assessing liver stiffness显示文摘AIM:To estimate the validity of the point shear-wave elastography method by evaluating its reproducibility and accuracy for assessing liver stiffness.METHODS:This was a single-center,cross-sectional study.Consecutive patients with chronic viral hepatitis scheduled for liver biopsy(LB)(Group 1)and healthy volunteers(Group 2)were studied.In each subject 10 consecutive point shear-wave elastography(PSWE)measurements were performed using the iU22 ultrasound system(Philips Medical Systems,Bothell,WA,United States).Patients in Group 1 underwent PSWE,transient elastography(TE)using FibroScan(Echosens,Paris,France)and ultrasound-assisted LB.For the assessment of PSWE reproducibility two expert raters(rater 1 and rater 2)independently performed the examinations.The performance of PSWE was compared to that of TE using LB as a reference standard.Fibrosis was staged according to the METAVIR scoring system.Receiver operating characteristic curve analyses were performed to calculate the area under the receiver operating characteristic curve(AUC)for F≥2,F≥3and F=4.The intraobserver and interobserver reproducibility of PSWE were assessed by calculating Lin’s concordance correlation coefficient.RESULTS:To assess the performance of PSWE,134consecutive patients in Group 1 were studied.The median values of PSWE and TE(in kilopascals)were 4.7(IQR=3.8-5.4)and 5.5(IQR=4.7-6.5),respectively,in patients at the F0-F1 stage and 3.5(IQR=3.2-4.0)and 4.4(IQR=3.5-4.9),respectively,in the healthy volunteers in Group 2(P<10-5).In the univariate analysis,the PSWE and TE values showed a high correlation with the fibrosis stage;low correlations with the degree of necroinflammation,aspartate aminotransferase and gamma-glutamyl transferase(GGT);and a moderate negative correlation with the platelet count.A multiple regression analysis confirmed the correlations of both PSWE and TE with fibrosis stage and GGT but not with any other variables.The following AUC values were found:0.80(0.71-0.87)for PSWE and 0.82(0.73-0.89)for TE(P=0.42);0.88(0.80-0.94)for PSWE and 0.95(0.88-0.98)for TE(P=0.06);and 0.95(0.89-0.99)for PSWE and 0.92(0.85-0.97)for TE(P=0.30)for F≥2,F≥3 and F=4,respectively.To assess PSWE reproducibility,116 subjects were studied,including 47consecutive patients scheduled for LB(Group 1)and 69 consecutive healthy volunteers(Group 2).The intraobserver agreement ranged from 0.83(95%CI:0.79-0.88)to 0.96(95%CI:0.95-0.97)for rater 1 and from 0.84(95%CI:0.79-0.88)to 0.96(95%CI:0.95-0.97)for rater 2.The interobserver agreement yielded values from0.83(95%CI:0.78-0.88)to 0.93(95%CI:0.91-0.95).CONCLUSION:PSWE is a reproducible method for assessing liver stiffness,and it compares with TE.Compared with patients with nonsignificant fibrosis,healthy volunteers showed significantly lower values. | Giovanna Ferraioli Carmine Tinelli Raffaella Lissandrin Mabel Zicchetti Barbara Dal Bello Gaetano Filice Carlo Filice | 2014 | World Journal of Gastroenterology2014,20,16: | 12 |
| 11 | Exposure to ambient air particulate matter and non-alcoholic fatty liver disease显示文摘The present study was designed to alert the public opinion and policy makers on the supposed enhancing effects of exposure to ambient air particulate matter with aerodynamic diameters < 2.5 mm (PM 2.5 ) on non-alcoholic fatty liver disease (NAFLD), the most common chronic liver disease in Western countries. For far too long literature data have been fixated on pulmonary diseases and/or cardiovascular disease, as consequence of particulate exposure, ignoring the link between the explosion of obesity with related syndromes such as NAFLD and air pollution, the worst characteristics of nowadays civilization. In order to delineate a clear picture of this major health problem, further studies should investigate whether and at what extent cigarette smoking and exposure to ambient air PM 2.5 impact the natural history of patients with obesity-related NAFLD,i.e. , development of non alcoholic steatohepatitis, disease characterized by a worse prognosis due its progression towards fibrosis and hepatocarcinoma. | Giovanni Tarantino Domenico Capone Carmine Finelli | 2013 | World Journal of Gastroenterology2013,19,25: | 11 |
| 12 | Association between serum vitamin D levels and gastric cancer:A retrospective chart analysis显示文摘AIM To determine whether there is an increased risk of gastric adenocarcinoma associated with vitamin D deficiency(VDd).METHODS A retrospective case control study was performed of all patients diagnosed with gastric adenocarcinoma between 2005 and 2015.After we excluded the patients without a documented vitamin D level,49 patients were included in our study.RESULTS The average age of patients with gastric adenocarcinoma and documented vitamin D level was 64 years old(95%CI: 27-86) and average vitamin D level was 20.8 mg/d L(95%CI: 4-44).Compared to a matched control group,the prevalence of VDd/insufficiency in patients with gastric adenocarcinoma was significantly higher than normal vitamin D levels(83.7% vs 16.3%).Forty-one patients(83.7%) with adenocarcinoma showed VDd/insufficiency compared to 18(37%) patients with normal vitamin D level without gastric cancer(OR: 8.8,95%CI: 5-22,P value < 0.0001).The average age of males with gastric adenocarcinoma diagnosis was 60 years old vs 68 years old for females(P = 0.01).StageⅡ gastric adenocarcinoma was the most prevalent in our study(37%).CONCLUSION We reported a positive relationship between VDd and gastric adenocarcinoma,that is to say,patients with decreased VDd levels have an increased propensity for gastric adenocarcinoma. | Neil Vyas Rafael Ching Companioni Melik Tiba Hassan Alkhawam Carmine Catalano Robert Sogomonian Joel Baum Aaron Walfish | 2016 | World Journal of Gastrointestinal Oncology2016,8,9: | 10 |
| 13 | Have guidelines addressing physical activity been established in nonalcoholic fatty liver disease?显示文摘The purpose of this review was to highlight, in relation to the currently accepted pathophysiology of non-alcoholic fatty liver disease (NAFLD), the known exercise habits of patients with NAFLD and to detail the benefits of lifestyle modification with exercise (and/or physical activity) on parameters of metabolic syndrome. More rigorous, controlled studies of longer duration and defined histopathological end-points comparing exercise alone and other treatment are needed before better, evidence-based physical activity modification guidelines can be established, since several questions remain unanswered. | Carmine Finelli Giovanni Tarantino | 2012 | World Journal of Gastroenterology2012,18,46: | 9 |
| 14 | Clinical significance of hepatitis B surface antigen mutants显示文摘Hepatitis B virus(HBV) infection is a major public health problem in many countries, with nearly 300 million people worldwide carrying HBV chronic infection and over 1 million deaths per year due to cirrhosis and liver cancer. Several hepatitis B surface antigen(HBs Ag) mutations have been described, most frequently due to a single amino acid substitution and seldom to a nucleotide deletion. The majority of mutations are located in the S region, but they have also been found in the pre-S1 and pre-S2 regions. Single amino acid substitutions in the major hydrophilic region of HBs Ag, called the 'a' determinant, have been associated with immune escape and the consequent failure of HBV vaccination and HBs Ag detection, whereas deletions in the pre-S1 or pre-S2 regions have been associated with the development of hepatocellular carcinoma. This review article will focus on the HBs Ag mutants and their biological and clinical implications. | Nicola Coppola Lorenzo Onorato Carmine Minichini Giovanni Di Caprio Mario Starace Caterina Sagnelli Evangelista Sagnelli | 2015 | World Journal of Hepatology2015,7,27: | 9 |
| 15 | A Likert Scale-Based Model for Benchmarking Operational Capacity,Organizational Resilience,and Disaster Risk Reduction显示文摘Likert scales are a common methodological tool for data collection used in quantitative or mixed-method approaches in multiple domains.They are often employed in surveys or questionnaires,for benchmarking answers in the fields of disaster risk reduction,business continuity management,and organizational resilience.However,both scholars and practitioners may lack a simple scale of reference to assure consistency across disciplinary fields.This article introduces a simple-to-use rating tool that can be used for benchmarking responses in questionnaires,for example,for assessing disaster risk reduction,gaps in operational capacity,and organizational resilience.We aim,in particular,to support applications in contexts in which the target groups,due to cultural,social,or political reasons,may be unsuitable for in-depth analyses that use,for example,scales from 1 to 7 or from 1 to 10.This methodology is derived from the needs emerged in our recent fieldwork on interdisciplinary projects and from dialogue with the stakeholders involved.The output is a replicable scale from 0 to 3 presented in a table that includes category labels with qualitative attributes and descriptive equivalents to be used in the formulation of model answers.These include examples of levels of resilience,capacity,and gaps.They are connected to other tools that could be used for in-depth analysis.The advantage of our Likert scale-based response model is that it can be applied in a wide variety of disciplines,from social science to engineering. | Gianluca Pescaroli Omar Velazquez Irasema Alcántara-Ayala Carmine Galasso Patty Kostkova David Alexander | 2020 | International Journal of Disaster Risk Science2020,11,3: | 8 |
| 16 | Laparoscopic approach to Meckel's diverticulum显示文摘AIM: To retrospective review the laparoscopic management of Meckel Diverticulum(MD) in two Italian Pediatric Surgery Centers.METHODS: Between January 2002 and December 2012, 19 trans-umbilical laparoscopic-assisted(TULA) procedures were performed for suspected MD. The children were hospitalized for gastrointestinal bleeding and/or recurrent abdominal pain. Median age at diagnosis was 5.4 years(range 6 mo-15 years). The study included 15 boys and 4 girls. All patients underwent clinical examination, routine laboratory tests, abdominal ultrasound and technetium-99m pertechnetate scan, and patients with bleeding underwent gastrointestinal endoscopy. The abdominal exploration was performed with a 10 mm operative laparoscope. Pneumoperitoneum was establishedbased on the body weight. Systematic overview of the peritoneal cavity allowed the ileum to be grasped with an atraumatic instrument. The complete exploration and surgical treatment of MD were performed extracorporeally, after intestinal exteriorization through the umbilicus. All patients' demographics, main clinical features, diagnostic investigations, operative time, histopathology reports, conversion rate, hospital stay and complications were registered and analyzed.RESULTS: MD was identified in 17 patients, while 1 had an ileal duplication and 1 a jejunal hemangioma. Fifteen patients had painless intestinal bleeding, while 4 had recurrent abdominal pain and exhibited cyst like structures in an ultrasound study. Eleven patients had a positive technetium-99m pertechnetate scan. In the patients with bleeding, gastrointestinal endoscopy did not name the source of hemorrhage. All patients were subjected to a TULA surgical procedure. An intestinal resection/anastomosis was performed in 14 patients, while 4 had a wedge resection of the diverticulum and 1 underwent stapling diverticulectomy. All surgical procedures were performed without conversion to open laparotomy. Mean operative time was 75 min(range 40-115 min). No major surgical complications were recorded. The median hospital stay was 5-7 d(range 4-13 d). All patients are asymptomatic at a median follow up of 4, 5 years(range 10 mo-10 years).CONCLUSION: Trans-umbilical laparoscopic-assisted Meckel's diverticulectomy is safe and effective in the treatment of MD, with excellent results. | Alfonso Papparella Fabiano Nino Carmine Noviello Antonio Marte Pio Parmeggiani Ascanio Martino Giovanni Cobellis | 2014 | World Journal of Gastroenterology2014,20,25: | 7 |
| 17 | Intestinal obstruction caused by torsed gangrenous Meckel's diverticulum encircling terminal ileum显示文摘Meckel's diverticulum(MD)is considered the most prevalent congenital anomaly of the gastrointestinal tract. It may result in a number of complications including hemorrhage,obstruction,and inflammation.Obstruction of various types is the most common presenting symptom in the adult population.Loop formations with the end of an MD and adjacent mesentery constricting the distal ileum is an uncommon cause of obstruction. Axial torsion and gangrene of MD is the rarest of the complications.The correct diagnosis of complicated MD before surgery is often difficult because this condition may mimic other acute abdominal pathologies.Delay in the diagnosis of a complicated MD can lead to signifi- cant morbidity and mortality.Here we describe the case of a patient with a very rare form of acute small bowel obstruction secondary to giant torsed gangrenous MD encircling the terminal ileum.To our knowledge, this co-occurrence of axial torsion and a loop-forming mechanism of obstruction has been reported only once in English medical literature. | Carmine Cartanese Tommaso Petitti Ernesto Marinelli Antonio Pignatelli Davide Martignetti Matteo Zuccarino Lucio Ferrozzi | 2011 | World Journal of Gastrointestinal Surgery2011,3,7: | 7 |
| 18 | Controlled attenuation parameter for evaluating liver steatosis in chronic viral hepatitis显示文摘AIM:To assess the performance of controlled attenuation parameter(CAP)in patients with chronic viral hepatitis.METHODS:CAP is a new technique that measures the attenuation in the liver of an ultrasound beam,which is directly related to lipid accumulation.Consecutive patients undergoing liver biopsy for chronic viral hepatitis were studied using the M probe of FibroScan device(Echosens,Paris,France).The device estimates liver st-eatosis in decibel per meter(dB/m).An expert operator performed all measurements.Steatosis was graded according to Kleiner’s classification.Pearson or Spearman rank coefficient was used to test correlation between two study variables.Linear regression was used for multivariate model to assess the association between CAP and other variables.Receiver operating characteristic curve analysis was performed to calculate area under the curve(AUROC)for S0 vs S1-S3 and S0-S1 vs S2-S3.RESULTS:115 subjects(85 males and 30 females)were prospectively studied.The mean values of CAP were 227.1±43.1 for S0;254.6±38.9 for S1;297.8±49.4 dB/m for S2-S3.In univariate analysis CAP showed a significant correlation with age,body mass index(BMI),degree of steatosis,and cholesterol.Multivariate regression analysis confirmed the correlation with the degree of steatosis[coefficient,1.2(0.60-1.83);P<10-5]and BMI[coefficient,4.1(0.5-7.8);P=0.03]but not with all other variables.Optimal cutoff values for S≥1 and S≥2 were 219 dB/m[AUROC,0.76(0.67-0.84);sensitivity,91.1%(78.8-97.5);specificity,51.6%(38.7-64.2);positive predictive value,56.9%(44.7-68.6);negative predictive value,89.2%(74.3-97.0);positive likelihood ratio,1.88(1.4-2.5);negative likelihood ratio,0.17(0.07-0.5)]and 296 dB/m[AUROC,0.82(0.74-0.89);sensitivity,60.0%(32.3-83.7);specificity,91.5%(83.9-96.3);positive predictive value,52.9%(27.8-77.0);negative predictive value,93.5%(86.3-97.6);positive likelihood ratio,7.05(3.2-15.4);negative likelihood ratio,0.44(0.2-0.8)],respectively.CONCLUSION:Controlled attenuation parameter could be a useful tool in the clinical management of patients with chronic viral hepatitis for detecting liver steatosis. | Giovanna Ferraioli Carmine Tinelli Raffaella Lissandrin Mabel Zicchetti Barbara Dal Bello Gaetano Filice Carlo Filice | 2014 | World Journal of Gastroenterology2014,20,21: | 7 |
| 19 | Stromal Elements Act to Restrain, Rather Than Support, Pancreatic Ductal Adenocarcinoma显示文摘 | Andrew D. Rhim Paul E. Oberstein Dafydd H. Thomas Emily T. Mirek Carmine F. Palermo Stephen A. Sastra Erin N. Dekleva Tyler Saunders Claudia P. Becerra Ian W. Tattersall C. Benedikt Westphalen Jan Kitajewski Maite G. Fernandez-Barrena Martin E. Fernandez- | 2014 | Cancer Cell2014,,: | 5 |
| 20 | Hepatic steatosis in overweight/obese females: New screening method for those at risk显示文摘AIM: To identify which parameters could help to distinguish the 'metabolically benign obesity', which is not accompanied by insulin resistance (IR) and early atherosclerosis.METHODS: Eighty two of 124 overweight/obese females formed the study population, which was divided into two groups (52 and 30 subjects, respectively) with and without IR according to a HO meostatic Metabolic Assessment (HOMA) cut-off of 2, and were studied in a cross-sectional manner. The main outcome measures were waist circumference, serum uric acid, high-density lipoprotein-cholesterol and triglycerides, alanine amino-transferase, blood pressure and the two imaging para-meters, hepatic steatosis and longitudinal diameter of the spleen, which were measured in relation to the presence/absence of IR. RESULTS: A variable grade of visceral obesity was observed in all subjects with the exception of three.Obesity of a severe grade was represented more in the group of IR individuals (P = 0.01). Hepatic steatosis, revealed at ultrasound, was more pronounced in IR than in non-IR subjects (P = 0.005). The two groups also demonstrated a clear difference in longitudinal spleen diameter and blood pressure, with raised and signif icant values in the IR group. Metabolic syndrome was frequent in the IR group, and was not modified when adjusted for menopause (P = 0.001). At linear regression, the β values of waist circumference and body mass index predicting HOMA were 0.295, P = 0.007 and 0.41, P = 0.0001, respectively. Measures of spleen longitudinal diameter were well predicted by body mass index (BMI) values, β = 0.35, P = 0.01, and by HOMA, β = 0.41, P = 0.0001. Blood pressure was predicted by HOMA values, β = 0.39, P = 0.0001). HOMA and hepatic steatosis were highly associated (rho = 0.34, P = 0.002). Interestingly, IR patients were almost twice as likely to have hepatic steatosis as non-IR patients. Among the MS criteria, blood pressure was very accurate in identifying the presence of IR (AUROC for systolic blood pressure 0.66, cut-off 125 mm of Hg, sensibility 64%, specif icity 75%; AUROC for diastolic blood pressure 0.70, cut-off 85 mm of Hg, sensibility 54.5%, specif icity 75%). CONCLUSION: As health care costs are skyrocketing, reliable and mainly inexpensive tools are advisable to better defi ne subjects who really need to lose weight. | Giovanni Tarantino Genoveffa Pizza Annamaria Colao Fabrizio Pasanisi Paolo Conca Patrizia Colicchio Carmine Finelli Franco Contaldo Carolina Di Somma Silvia Savastano | 2009 | World Journal of Gastroenterology2009,15,45: | 4 |