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| 1 | Is there a real diagnostic impact of elastosonography and contrast-enhanced ultrasonography in the management of thyroid nodules?显示文摘Ultrasonography(US) and the new applications US elastography(USE) and contrast-enhanced US(CEUS) are used in the screening of thyroid nodules,for which fine-needle aspiration biopsy(FNAB) is the best single diagnostic test.The aim of the study was to compare the sensitivity,specificity,positive predictive value(PPV),and accuracy of the four examinations in nodules with cytological and histological diagnoses.The study used data from US,FNAB,USE(elasticity(ELX 2/1) index),and CEUS(Peak index and time to peak(TTP) index) evaluated in 73 thyroid nodules in 63 consecutive patients likely to undergo surgery.Cytological-histological correlation was available for 38 nodules.No correlation emerged between nodule size and cytological results.A significant(P=0.03) positive correlation between cumulative US findings and cytological results was found.In addition,significant correlations between cumulative US findings and cytology(P=0.02) and between cumulative US findings and histology(P<0.0001) were found.US showed the best specificity and PPV,and FNAB the best sensitivity.There was no significant difference in the ELX 2/1 index,Peak index,or TTP index among nodules subdivided according to cytological scores.No significant correlation was found between ELX 2/1 index,Peak index,and TTP index,on the one hand,and nodule size,US cumulative findings,cytology,and histology on the other hand.The sensitivity of the ELX 2/1 index was high,but its specificity was very low.The accuracy and PPV of USE were lower than those of the other procedures.Only the correlation between Peak index and cumulative US findings reached a value close to significance.Our ultimate aim is to minimise unnecessary thyroidectomy.US and FNAB continue to play a central diagnostic role.The use of a US score showed high specificity and PPV.The specificity of FNAB was low in this selected series because of the numbers of indeterminate cytological responses.USE and CEUS are innovative techniques that need to be standardized.The ELX 2/1 index,Peak index,and TTP index seem to be unrelated to histology.The best statistical data on USE and CEUS concerned their sensitivity and PPV,respectively.At present,USE and CEUS are too time-consuming and of limited utility in selecting patients for surgery. | Massimo GIUSTI Davide ORLANDI Giulia MELLE Barbara MASSA Enzo SILVESTRI Francesco MINUTO Gianni TURTULICI | 2013 | Journal of Zhejiang University-Science B(Biomedicine & Biotechnology)2013，14，3： | 17 |
| 2 | Clinical impact of selective transarterial chemoembolization on hepatocellular carcinoma:A cohort study显示文摘AIM:To prospectively evaluate the short and long term clinical impact of selective transarterial chemoembolization (TACE) on liver function in patients with hepatocellular carcinoma (HCC).To assess side effects in relation to treatments.To analyze the overall survival and HCC progression free survival probability. METHODS:One hundred and seventeen cirrhotic patients with HCC were enrolled.Baseline liver function included Child-Pugh score and serum levels of alanineaminotransferase (ALT),prothrombin time(PT)and bilirubin.According to Cancer Liver Italian Program (CLIP) and Barcelona Clinic Liver Cancer (BCLC) staging systems,71 patients were eligible for TACE; 32 had previously received treatment for HCC.No significant differences in liver function were observed between previously treated and not treated patients. TACE was performed by selective catheterization of the arteries nourishing the lesions.While hospitalized, patient sunder went clinical,hematologicand ultrasonographic assessments.One month after TACE a CT scan was performed to assess tumor response. A second TACE was performed'on demand'.Liver function tests were checked in all patients every four months.RESULTS:After first TACE,the mean Child-Pugh score increased from a mean baseline 5.62±1.12 to 6.11±1.57 at discharge time (P<0.0001),decreasing after four months to 5.81±0.73 (not significant).ALT,PT and bilirubin significantly (P<0.0001)increased 24 h after TACE and progressively decreased until discharge. After the second TACE,variations in Child-Pugh score,ALT,PT and bilirubin were comparable to that described after the first TACE.No major complications were observed.The mean follow-up was 14.7±6.3 mo (median:16 mo).Only one patient died.No other patient experienced important long term worsening of clinical status.The overall survival probability at twenty-four months was 98.18%with a correspondent HCC progression free survival probability of 69%. CONCLUSION:Selectiv TAC Emayproduce significant,but transitory increases in ALT values, with no major impact on liver function and Child-Pugh score.Preservation of liver function is achievable also in patients previously treated with other therapeutic modalities and in patients undergoing multiple TACE cycles.Liver function can remain stable in the long-term, with optimal medium term survival.This result can be achieved through rigorous patient selection on the basis of tumour characteristics and clinical conditions. | Rodolfo Sacco Marco Bertini Pasquale Petruzzi Michele Bertoni Irene Bargellini Giampaolo Bresci Graziana Federici Luigi Gambardella Salvatore Metrangolo Giuseppe Parisi Antonio Romano Antonio Scaramuzzino Emanuele Tumino Alessandro Silvestri Emanuele Altomare Claudio Vignali Alfonso Capria | 2009 | World Journal of Gastroenterology2009，15，15： | 7 |
| 3 | Carrier frequency of HLA-DQB1*02 allele in patients affected with celiac disease:A systematic review assessing the potential rationale of a targeted allelic genotyping as a first-line screening显示文摘BACKGROUND Celiac Disease(CD)is an immune-mediated disorder,in which the HLA immunogenetic background(DQ2 and DQ8 heterodimers)and environmental trigger(gluten)are well established.Indeed,both factors are necessary–but not sufficient–to develop CD.However,it is very likely that CD is underdiagnosed in both developing and developed countries,due to several aspects,including the fact that a lot of patients present mild and/or atypical symptoms,without the presence of any recognized risk factors.Therefore,the possibility and feasibility of widened screening strategies to identify CD patients are debated.AIM To provide further evidence of the main epidemiological importance of HLADQB1*02 allele in the population of CD patients.METHODS We performed a systematic search in PubMed,EMBASE,Cochrane,Web of Science and Scopus databases,in order to produce a systematic review assessing the carrier frequency of HLA-DQB1*02 allele in the celiac population.Following the PRISMA guidelines,we retrieved all the original articles describing CD patients’HLA-DQB1 genotype in such a way that could allow to assess the HLADQB1*02 carrier frequency among CD patients,along with the evidence of the appropriate diagnostic work-up to achieve a correct and final diagnosis of CD.RESULTS The final output of this systematic search in the medical literature consisted of 38 studies providing the appropriate HLA-DQB1 genotype information of the respective CD population.According to this systematic review,including a pool of 4945 HLA-DQ genotyped CD patients,the HLA-DQB1*02 carrier frequency was 94.94%,meaning that only 5.06%of CD patients were completely lacking this allelic variant.Interestingly,if we consider only the studies whereby the prevalence of CD patients affected with type 1 diabetes mellitus was supposed or clearly established to be very low,the frequency of non-HLA-DQB1*02 carriers among CD patients dropped to 3.65%.CONCLUSION Such a high carrier frequency of the HLA-DQB1*02 allelic variant(which is>95%-96%in CD patients without risk factors,like type 1 diabetes mellitus comorbidity)might be exploited to consider a cost-effective and widened screening approach.If a sustainable strategy could be implemented through a low-cost targeted genetic test to detect the individual presence of HLA-DQB1*02 allele,an appropriate algorithm for serological screening in individuals resulting to be genetically predisposed to CD,might be considered. | Dimitri Poddighe Chiara Rebuffi Annalisa De Silvestri Cristina Capittini | 2020 | World Journal of Gastroenterology2020，26，12： | 5 |
| 4 | Molecular classifications of gastric cancers: Novel insights and possible future applications显示文摘Despite some notable advances in the systemic management of gastric cancer(GC), the prognosis of patients with advanced disease remains overall poor and their chance of cure is anecdotic. In a molecularly selected population, a median overall survival of 13.8 mo has been reached with the use of human epidermal growth factor 2(HER2) inhibitors in combination with chemotherapy, which has soon after become the standard of care for patients with HER2-overexpressing GC. Moreover, oncologists have recognized the clinical utility of conceiving cancers as a collection of different molecularlydriven entities rather than a single disease. Several molecular drivers have been identified as having crucial roles in other tumors and new molecular classifications have been recently proposed for gastric cancer as well. Not only these classifications allow the identification of different tumor subtypes with unique features, but also they serve as springboard for the development of different therapeutic strategies. Hopefully, the application of standard systemic chemotherapy, specifictargeted agents, immunotherapy or even surgery in specific cancer subgroups will help maximizing treatment outcomes and will avoid treating patients with minimal chance to respond, therefore diluting the average benefit. In this review, we aim at elucidating the aspects of GC molecular subtypes, and the possible future applications of such molecular analyses. | Silvio Ken Garattini Debora Basile Monica Cattaneo Valentina Fanotto Elena Ongaro Marta Bonotto Francesca V Negri Rosa Berenato Paola Ermacora Giovanni Gerardo Cardellino Mariella Giovannoni Nicoletta Pella Mario Scartozzi Lorenzo Antonuzzo Nicola Silvestris Gianpiero Fasola Giuseppe Aprile | 2017 | World Journal of Gastrointestinal Oncology2017，9，5： | 5 |
| 5 | Total and not bevacizumab-bound vascular endothelial growth factor as potential predictive factors to bevacizumab-based chemotherapy in colorectal cancer显示文摘AIM: To identify suitable biomarkers of response to bevacizumab(BV)- it remains an open question. The measurement of serum vascular endothelial growth factor(VEGF) has been proposed as a predictive factor for this drug, even if literature data are contradictory. METHODS: We prospectively evaluated the role of BV, total and not BV-bound VEGF and angiopoietin-2(Ang-2) serum levels as potential predictive factors of response for BV in combination with an oxaliplatinbased chemotherapy. BV, Ang-2, total and not BVbound VEGF levels were measured at baseline, before 2^(nd) and 5^(th) cycle of oxaliplatin-based chemotherapy in 20 consecutive metastatic colorectal cancer patients. RESULTS: Results were correlated to response to treatment. Variability in BV levels have been found, with decreased level in less responding patients. In particular, the concentration of BV increased of 3.96 ± 0.69 folds in serum of responsive patients after 3 more cycles of therapy compared to those with stable or progressive disease with a 0.72 ± 0.25 and 2.10 ± 0.13 fold increase, respectively. The determination of free and total VEGF demonstrated that the ratio between the two values, evaluated immediately before the 2^(nd) and the 5^(th) cycle of therapy, decreased from 26.65% ± 1.33% to 15.50% ± 3.47% in responsive patients and from 53.41% ± 4.75 to 34.95% ± 2.88% in those with stable disease. Conversely, in those with progression of disease, the ratio showed the opposite behavior coming up from 25.99% ± 5.23% to 51.71% ± 5.28%. The Ang-2 levels did not show any relationship. CONCLUSION: Our data show that the ratio of not BV-bound VEGF to total VEGF serum and BV plasma concentrations for predicting the response to BV plus oxaliplatin-based chemotherapy could be a promising biomarker of response to BV. | Amalia Azzariti Letizia Porcelli Oronzo Brunetti Marzia Del Re Vito Longo Patrizia Nardulli Michele Signorile Jian-Ming Xu Angela Calabrese Anna Elisa Quatrale Evaristo Maiello Vito Lorusso Nicola Silvestris | 2016 | World Journal of Gastroenterology2016，22，27： | 4 |
| 6 | Thyroid hormone analogues and derivatives:Actions in fatty liver显示文摘Fatty liver or nonalcoholic fatty liver disease(NAFLD),a problem of increasing clinical significance and prevalence worldwide,is associated with increased risk for the development of cirrhosis and hepatocellular carcinoma.Although several therapeutic approaches can be used in the context of NAFLD,dietary and physical activities are still the most frequently used strategies.Some pharmacological agents show promising results although no conclusions can be drawn from recent clinical trials.Thyroid hormones[THs;thyroxine(T4)and3,3′,5-triiodo-L-thyronine(T3)]coordinate a diverse array of physiological events during development and lipid/energy homeostasis and have some potentially therapeutic actions which include inducing weight loss,and lowering plasma cholesterol levels and tissue adiposity.The thyroid hormones exert their physiological effects by binding to specific nuclear receptors[thyroid hormone receptors(TR)]of which the TRβisoform is liver specific and has been considered a putative target for the treatment of dyslipidemia and fatty liver.In view of this,the aim of the review is(1)to provide an overview of the action of T3 on lipid metabolism with implications for liver steatosis and(2)to provide an update on the current knowledge concerning the administration of TRβselective thyromimetics(GC-1 and MB07811),as well as of 3,5-diiodo-L-thyronine and its novel functional analogue TRC150094 in animal models of overweight and related disorders including primarily fatty liver. | Maria Coppola Daniela Glinni Maria Moreno Federica Cioffi Elena Silvestri Fernando Goglia | 2014 | World Journal of Hepatology2014，6，3： | 3 |
| 7 | Resveratrol corrects aberrant splicing of RYR1 pre-mRNA and Ca2+ signal in myotonic dystrophy type 1 myotubes显示文摘Myotonic dystrophy type 1(DM1) is a spliceopathy related to the mis-splicing of several genes caused by sequestration of nuclear transcriptional RNA-binding factors from non-coding CUG repeats of DMPK pre-mRNAs. Dysregulation of ryanodine receptor 1(RYR1), sarcoplasmatic/endoplasmatic Ca^2+-ATPase(SERCA) and α1 S subunit of voltage-gated Ca^2+ channels(Cav1.1) is related to Ca^2+ homeostasis and excitation-contraction coupling impairment. Though no pharmacological treatment for DM1 exists, aberrant splicing correction represents one major therapeutic target for this disease. Resveratrol(RES, 3,5,4′-trihydroxy-trans-stilbene) is a promising pharmacological tools for DM1 treatment for its ability to directly bind the DNA and RNA influencing gene expression and alternative splicing. Herein, we analyzed the therapeutic effects of RES in DM1 myotubes in a pilot study including cultured myotubes from two DM1 patients and two healthy controls. Our results indicated that RES treatment corrected the aberrant splicing of RYR1, and this event appeared associated with restoring of depolarization-induced Ca^2+ release from RYR1 dependent on the electro-mechanical coupling between RYR1 and Cav1.1. Interestingly, immunoblotting studies showed that RES treatment was associated with a reduction in the levels of CUGBP Elav-like family member 1, while RYR1, Cav1.1 and SERCA1 protein levels were unchanged. Finally, RES treatment did not induce any major changes either in the amount of ribonuclear foci or sequestration of muscleblind-like splicing regulator 1. Overall, the results of this pilot study would support RES as an attractive compound for future clinical trials in DM1. Ethical approval was obtained from the Ethical Committee of IRCCS Fondazione Policlinico Universitario A. Gemelli, Rome, Italy(rs9879/14) on May 20, 2014. | Massimo Santoro Roberto Piacentini Alessia Perna Eugenia Pisano Anna Severino Anna Modoni Claudio Grassi Gabriella Silvestri | 2020 | Neural Regeneration Research2020，15，9： | 3 |
| 8 | Endoscopic ultrasound diagnostic gain over computed tomography and magnetic resonance cholang-iopancreatography in defining etiology of idiopathic acute pancreatitis显示文摘BACKGROUND About 10%-30%of acute pancreatitis remain idiopathic(IAP)even after clinical and imaging tests,including abdominal ultrasound(US),contrast-enhanced computed tomography(CECT)and magnetic resonance cholangiopancreatography(MRCP).This is a relevant issue,as up to 20%of patients with IAP have recurrent episodes and 26%of them develop chronic pancreatitis.Few data are available on the role of EUS in clarifying the etiology of IAP after failure of one or more cross-sectional techniques.AIM To evaluate the diagnostic gain after failure of one or more previous crosssectional exams.METHODS We retrospectively collected data about consecutive patients with AP and at least one negative test between US,CECT and MRCP,who underwent linear EUS between January 2017 and December 2020.We investigated the EUS diagnostic yield and the EUS diagnostic gain over different combinations of these crosssectional imaging techniques for the etiologic diagnosis of AP.Types and frequency of EUS diagnosis were also analyzed,and EUS diagnosis was compared with the clinical parameters.After EUS,patients were followed-up for a median of 31.5 mo to detect cases of pancreatitis recurrence.RESULTS We enrolled 81 patients(63%males,mean age 61±18,23%with previous cholecystectomy,17%with recurrent pancreatitis).Overall EUS diagnostic yield for AP etiological diagnosis was 79%(20%lithiasis,31%acute on chronic pancreatitis,14%pancreatic solid or cystic lesions,5%pancreas divisum,5%autoimmune pancreatitis,5%ductal abnormalities),while 21%remained idiopathic.US,CECT and MRCP,taken alone or in combination,led to AP etiological diagnosis in 16(20%)patients;among the remaining 65 patients,49(75%)obtained a diagnosis at EUS,with an overall EUS diagnostic gain of 61%.Sixty-eight patients had negative US;among them,EUS allowed etiological diagnosis in 59(87%).Sixty-three patients had a negative CECT;among them,47(74%)obtained diagnosis with EUS.Twenty-four had a negative MRCP;among them,20(83%)had EUS diagnosis.Twenty-one had negative CT+MRCP,of which 17(81%)had EUS diagnosis,with a EUS diagnostic gain of 63%.Patients with biliary etiology and without previous cholecystectomy had higher median values of alanine aminotransferase(154 vs 25,P=0.010),aspartate aminotransferase(95 vs 29,P=0.018),direct bilirubin(1.2 vs 0.6,P=0.015),gammaglutamyl transpeptidase(180 vs 48,P=0.006)and alkaline phosphatase(150 vs 72,P=0.015)Chronic pancreatitis diagnosis was more frequent in patients with recurrent pancreatitis at baseline(82%vs 21%,P<0.001).During the follow-up,AP recurred in 3 patients,one of which remained idiopathic.CONCLUSION EUS is a good test to define AP etiology.It showed a 63%diagnostic gain over CECT+MRCP.In suitable patients,EUS should always be performed in cases of IAP.Further prospective studies are needed. | Stefano Mazza Biagio Elvo Clara Benedetta Conti Andrea Drago Maria Chiara Verga Sara Soro Annalisa De Silvestri Fabrizio Cereatti Roberto Grassia | 2022 | World Journal of Gastrointestinal Endoscopy2022，14，6： | 3 |
| 9 | Clinical epidemiology of chronic viral hepatitis B:A Tuscany real-world large-scale cohort study显示文摘AIM To build a regional database of chronic patients to define the clinical epidemiology of hepatitis B virus(HBV)-infected patients in the Tuscan public health care system.METHODS This study used a cross-sectional cohort design. We evaluated chronic viral hepatitis patients with HBV referred to the outpatient services of 16 hospital units. Information in the case report forms included main demographic data, blood chemistry data, viral hepatitis markers, instrumental evaluations, and eligibility for treatment or ongoing therapy and liver transplantation. RESULTS Of 4015 chronic viral hepatitis patients, 1096(27.3%) were HBV infected. The case report form was correctly completed for only 833 patients(64% males, 36% females; mean age 50.1 ± 15.4). Of these HBV-infected patients, 73% were Caucasian, 21% Asian, 4% Central African, 1% North African and 1% American. Stratifying patients by age and nationality, we found that 21.7% of HBV-infected patients were aged < 34 years(only 2.8% were Italian). The most represented routes of transmission were nosocomial/dental procedures(23%), mother-to-child(17%) and sexual transmission(12%). The most represented HBV genotypes were D(72%) and A(14%). Of the patients, 24.7% of patients were HBe Ag positive, and 75.3% were HBe Ag negative. Of the HBV patients 7% were anti-HDV positive. In the whole cohort, 26.9% were cirrhotic(35.8% aged < 45 years), and 47% were eligible for or currently undergoing treatment, of whom 41.9 % were cirrhotic. CONCLUSION Only 27.3% of chronic viral hepatitis patients were HBV infected. Our results provide evidence of HBV infection in people aged < 34 years, especially in the foreign population not protected by vaccination. In our cohort of patients, liver cirrhosis was also found in young adults. | Cristina Stasi Caterina Silvestri Roberto Berni Maurizia Rossana Brunetto Anna Linda Zignego Cristina Orsini Stefano Milani Liana Ricciardi Andrea De Luca Pierluigi Blanc Cesira Nencioni Donatella Aquilini Alessandro Bartoloni Giampaolo Bresci Santino Marchi Franco Filipponi Piero Colombatto Paolo Forte Andrea Galli Sauro Luchi Silvia Chigiotti Alessandro Nerli Giampaolo Corti Rodolfo Sacco Paola Carrai Angelo Ricchiuti Massimo Giusti Paolo Almi Andrea Cozzi Silvia Carloppi Giacomo Laffi Fabio Voller Francesco Cipriani | 2018 | World Journal of Hepatology2018，10，5： | 3 |
| 10 | Eye reflux:an ocular extraesophageal manifestation of gastric reflux显示文摘AIM: To suspect laryngopharyngeal reflux(LPR) in patients with ocular surface disease(OSD). METHODS: The present study evaluated a group of subjects with OSD assessing the Ocular Surface Disease Index(OSDI) and the Reflux Symptom Index(RSI) to detect patients with suspected LPR and define a possible relationship between tests.RESULTS: Two hundred and ninety subjects(175 females, mean age: 60.41±15.68y) were consecutively visited at ophthalmologist offices. One hundred and one(34%) patients had pathological RSI(>13) and consequently a suspected LPR.CONCLUSION: The current study shows that suspected LPR may be common(34%) in patients with OSD and a suspected LPR may be considered in OSD patients when RSI score is >13 and OSDI score is >42. | Danilo Mazzacane Valerio Damiani Michela Silvestri Giorgio Ciprandi Pierfranco Marino | 2018 | International Journal of Ophthalmology(English edition)2018，11，9： | 2 |
| 11 | Humoral Response to Recombinant Hepatitis B Virus Vaccine at Birth: Role of HLA and Beyond显示文摘 | Miryam Martinetti Annalisa De Silvestri Cesare Belloni Annamaria Pasi Carmine Tinelli Angela Pistorio Laura Salvaneschi Giorgio Rondini Maria Antonia Avanzini Mariaclara Cuccia | 2000 | Clinical Immunology2000，，： | 2 |
| 12 | Pump power stability range of single solid state lasers with rod thermal lensing显示文摘 | Silvestri S D Laporta P Magni V | 1987 | IEEE J Quantum Electronics1987，23，11： | 2 |
| 13 | Endoscopic ultrasound with frae - needle aspiration in the diagnosis and staging of lung cancer显示文摘 | Silvestri GA Hoffman BJ Bhutani MS | 1996 | Ann Thorac Surg1996，61，5： | 2 |
| 14 | Target Therapies in Pancreatic Carcinoma显示文摘 | Nicola Silvestris Antonio Gnoni Anna Elisabetta Brunetti Leonardo Vincenti Daniele Santini Giuseppe Tonini Francesca Merchionne Evaristo Maiello Vito Lorusso Patrizia Nardulli Amalia Azzariti Michele Reni | 2014 | Current Medicinal Chemistry2014，，8： | 2 |
| 15 | Hepatitis B and C virus infections as possible risk factor for pancreatic adenocarcinoma显示文摘 | S. Fiorino S. Lorenzini M. Masetti G. Deleonardi A.G. Grondona T. Silvestri E. Chili P. Del Prete L. Bacchi-Reggiani A. Cuppini E. Jovine | 2012 | Medical Hypotheses2012，，5： | 2 |
| 16 | Ultrafast charge transfer in conjugated polymer-fullerene composites显示文摘 | G. Zerza C.J. Brabec G. Cerullo S. De Silvestri N.S. Sariciftci | 2001 | Synthetic Metals2001，，1： | 2 |
| 17 | Survival benefit of the full selective digestive decontamination regimen显示文摘 | Luciano Silvestri Hendrick K.F. van Saene Ian Weir Antonino Gullo | 2009 | Journal of Critical Care2009，，3： | 2 |
| 18 | Pulmonary complications after esophagectomy显示文摘 | Christopher E Avendano Patrick A Flume Gerard A Silvestri Lydia B King Carolyn E Reed | 2002 | The Annals of Thoracic Surgery2002，，3： | 2 |
| 19 | Investigation of the microbial ecology of Ciauscolo, a traditional Italian salami, by culture-dependent techniques and PCR-DGGE显示文摘 | Gloria Silvestri Sara Santarelli Lucia Aquilanti Alessandra Beccaceci Andrea Osimani Franco Tonucci Francesca Clementi | 2007 | Meat Science2007，，3： | 2 |
| 20 | Optimize radiochemotherapy in pancreatic cancer: PARP inhibitors a new therapeutic opportunity显示文摘 | Letizia Porcelli Anna E. Quatrale Paola Mantuano Maria G. Leo Nicola Silvestris Jean F. Rolland Enza Carioggia Marco Lioce Angelo Paradiso Amalia Azzariti | 2013 | Molecular Oncology2013，，3： | 2 |
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