Purpureocillium lilacinum(formerly Paecilomyces lilacinus)is a hyaline hyphomycete with a ubiquitous distribution.In the last decade this fungus has been increasingly found as the causal agent of infections in humans ...Purpureocillium lilacinum(formerly Paecilomyces lilacinus)is a hyaline hyphomycete with a ubiquitous distribution.In the last decade this fungus has been increasingly found as the causal agent of infections in humans and other vertebrates.It is an emerging opportunistic pathogen and is increasingly reported,and can cause a wide spectrum of clinical manifestations,especially among immunocompromised patients or following surgical procedures.The pathogenic mechanisms are not yet fully understood.Ocular and cutaneous/subcutaneous infections are the most familiar clinical presentations,and these can also cause disseminated infections.Early and accurate species identification and suscept-ibility testing are vital.In general,surgical debridement combined with antifungal drug therapy,or the correction of predisposing factors,are usually required to obtain improvement.Infections present a therapeutic challenge,as they have intrinsic resistance to many antifungal agents,but voriconazole and posaconazole are good in vitro activity.The overall mortality was 22%and death was attributed to the infection in 46%of cases.Accurate diagnoses can be achieved through newer molecular biological techniques,and these can lead to appropriate management of infections due to this organism.Future studies should ideally aim to elucidate pathogenesis and determine more effective diagnoses and effective antifungal treatment.展开更多
The coronavirus disease 2019(COVID-19)pandemic has caused detrimental effects on many aspects of healthcare practice.Screening programs for the commonest malignancies,namely colorectal cancer(CRC),breast cancer and ce...The coronavirus disease 2019(COVID-19)pandemic has caused detrimental effects on many aspects of healthcare practice.Screening programs for the commonest malignancies,namely colorectal cancer(CRC),breast cancer and cervical cancer have been discontinued or interrupted since the beginning of restriction measures aimed to limit transmission of the new coronavirus infection.Robust evidence exists in favour of the role of screening campaigns in reducing mortality from CRC.In fact,the majority of pre-malignant lesions of the colon and rectum can be diagnosed with colonoscopy and treated by endoscopic or surgical resection.Besides,colonoscopy screening allows the diagnosis of CRCs in their pre-clinical stage.Italy was one of the first European countries where a high level of COVID-19 infections and deaths was observed,and one of the first where lockdowns and strict measures were adopted to reduce the risk of COVID-19 diffusion among the population.A systematic review of the literature was performed,including the PubMed,Scopus,Web of Sciences,and Reference Citation Analysis databases,with the aim of critically evaluating the impact of the COVID-19 pandemic on CRC screening in Italy.We found that reduction of CRC screening activity surpassed 50%in most endoscopic units,with almost 600000 fewer CRC screening exams conducted in the first 5 mo of 2020 vs the same period of 2019.While the consequences of the discontinuation of endoscopy screening for the prognosis and mortality of CRC will be evident in the next few years,recent data confirm that CRC is currently treated at a more advanced stage than in the pre-COVID-19 era.Since delays in CRC prevention and early diagnosis may translate to increased CRC-specific mortality,world healthcare systems should adopt strategies to maintain the regularity of CRC screening during subsequent peaks of the COVID-19 pandemic,or future events that might hamper screening programs.展开更多
The incidence of hepatocellular carcinoma(HCC)has been steadily rising,und-erscoring the need for a clear,stage-specific treatment approach.The Barcelona Clinic Liver Cancer(BCLC)staging system remains the most widely...The incidence of hepatocellular carcinoma(HCC)has been steadily rising,und-erscoring the need for a clear,stage-specific treatment approach.The Barcelona Clinic Liver Cancer(BCLC)staging system remains the most widely used frame-work for classifying HCC and guiding therapy.Among its classifications,the intermediate stage(BCLC-B)encompasses a highly heterogeneous patient popu-lation,with varying degrees of tumor burden and liver function.Traditionally,transarterial chemoembolization has been the standard treatment for this stage,based on earlier evidence.However,recent studies suggest that a subset of BCLC-B patients-particularly those with localized disease-may benefit more from liver resection.This review summarizes current treatment paradigms for BCLC-B HCC,explores emerging subclassifications within this group,and highlights evolving guidelines that support the selective use of surgery in appropriately chosen patients.展开更多
Deep transcranial magnetic stimulation(DTMS)is a new non-invasive neuromodulation technique based on repetitive transcranial magnetic stimulation technology.The new H-coil has significant advantages in the treatment a...Deep transcranial magnetic stimulation(DTMS)is a new non-invasive neuromodulation technique based on repetitive transcranial magnetic stimulation technology.The new H-coil has significant advantages in the treatment and mechanism research of psychiatric and neurological disorders.This is due to its deep stimulation site and wide range of action.This paper reviews the clinical progress of DTMS in psychiatric and neurological disorders such as Parkinson’s disease,Alzheimer’s disease,post-stroke motor dysfunction,aphasia,and other neurological disorders,as well as anxiety,depression,and schizophrenia.展开更多
BACKGROUND Risk stratification for patients with gastric precancerous lesions for endoscopic surveillance remains controversial.AIM To analysis of patients having developed gastric adenocarcinoma during the period of ...BACKGROUND Risk stratification for patients with gastric precancerous lesions for endoscopic surveillance remains controversial.AIM To analysis of patients having developed gastric adenocarcinoma during the period of follow-up.METHODS We conducted a retrospective study on patients having undergone upper endoscopy prior to the development of gastric adenocarcinoma. The presence and stage of precancerous lesions as well as subtype of intestinal metaplasia at the baseline endoscopy got evaluated. Literature mini-review was performed.RESULTS Out of 1681 subjects in the Biobank, gastric adenocarcinoma was detected in five cases in whom previous endoscopy data with biopsies either from the corpus or antral part were available. All of the patients had incomplete intestinal metaplasia during the baseline endoscopy;all three subjects in whom intestinal metaplasia subtyping was performed according to Filipe et al, had Type Ⅲ intestinal metaplasia. Two of the five cases had low Operative Link on Gastritis Assessment(OLGA) and Operative Link on Gastritis Intestinal Metaplasia Assessment(OLGIM) stages(Ⅰ-Ⅱ) at the baseline.CONCLUSION The presence of incomplete intestinal metaplasia, in particular, that of Type Ⅲ is a better predictor for gastric adenocarcinoma development than OLGA/OLGIM staging system. Subtyping of intestinal metaplasia have an important role in the risk stratification for surveillance decisions.展开更多
Nonalcoholic fatty liver disease(NAFLD)is the most common chronic liver disease,leading to fibrosis,cirrhosis and hepatocellular carcinoma and also associated with increased cardiovascular disease mortality.The pathog...Nonalcoholic fatty liver disease(NAFLD)is the most common chronic liver disease,leading to fibrosis,cirrhosis and hepatocellular carcinoma and also associated with increased cardiovascular disease mortality.The pathogenesis of NAFLD is not fully understood,although NAFLD is thought to be a hepatic form of metabolic syndrome.There is an increasing understanding of the role of microbiota disturbances in NAFLD pathogenesis,and as with many other conditions affecting the microbiota,NAFLD may be a novel risk factor for Clostridioides difficile(C.difficile)colonization(CDC)and C.difficile infection(CDI).CDI is an emerging nosocomial disease,and community-acquired cases of infection are growing,probably due to an increase in CDC rates.The association of NAFLD with CDI has been shown in only 4 studies to date,three of which included less than 1000 patients,although the frequency of NAFLD in these studies was observed in almost 20%of the total patient cohort.These data revealed that NAFLD is a risk factor for CDI development and,moreover,is a risk factor for intestinal complications of CDI.More studies are needed to investigate this association and move forward CDC and CDI screening efforts for this group of patients.展开更多
The variability of vascular anatomy of the pancreas underlines the difficulty of its transplantation.Research regarding the consistency of anatomical variations shows splenic arterial dominance in most cases.This can ...The variability of vascular anatomy of the pancreas underlines the difficulty of its transplantation.Research regarding the consistency of anatomical variations shows splenic arterial dominance in most cases.This can significantly improve transplantation success.A systematic literature review was performed according to the quality standards described in the AMSTAR measurement tool and the PRISMA guidelines.We valuated existing literature regarding the vascularization and blood perfusion patterns of the pancreas in terms of dominance and variability.The collected data was independently analyzed by two researchers.Variance of vascular anatomy was seen to be underreported in literature,though significant findings have been included and discussed in this study,providing valuable insight into the dynamics of pancreatic perfusion and feasibility of transplantation on several different supplying arteries.The splenic artery(SA)has a high percentage of consistency in all found studies(over 90%).High frequency of anastomoses between arterial pools supplying the pancreas can mediate sufficient blood supply through a dominant vessel,such as the SA,which is present in most cases.Pancreatic transplantation with isolated SA blood supply can provide sufficient arterial perfusion of the pancreas for stable transplant viability due to high anatomical consistency of the SA and vast communications with other arterial systems.展开更多
The coronavirus disease 2019(COVID-19)disease was first detected in December 2019 in Wuhan,China.This disease is currently one of the most important global health problems.The novel coronavirus COVID-19 is a respirato...The coronavirus disease 2019(COVID-19)disease was first detected in December 2019 in Wuhan,China.This disease is currently one of the most important global health problems.The novel coronavirus COVID-19 is a respiratory illness,that has caused a deadly pandemic that is spreading rapidly around the world.It is not only a respiratory system virus that causes severe lung disease,but also a systemic disease agent that can affect all systems.People with COVID-19 disease usually have respiratory signs,however,the liver disorder is not an uncommon presentation.In addition,many studies around the world have revealed that the liver is injured to various degrees in patients with severe acute respiratory syndrome coronavirus 2 disease.This review mainly focuses on the impact of COVID-19 on Liver Injury at various ages.展开更多
基金Supported by The Japan Society for the Promotion of Science KAKENHI Grant,No.24K15491.
文摘Purpureocillium lilacinum(formerly Paecilomyces lilacinus)is a hyaline hyphomycete with a ubiquitous distribution.In the last decade this fungus has been increasingly found as the causal agent of infections in humans and other vertebrates.It is an emerging opportunistic pathogen and is increasingly reported,and can cause a wide spectrum of clinical manifestations,especially among immunocompromised patients or following surgical procedures.The pathogenic mechanisms are not yet fully understood.Ocular and cutaneous/subcutaneous infections are the most familiar clinical presentations,and these can also cause disseminated infections.Early and accurate species identification and suscept-ibility testing are vital.In general,surgical debridement combined with antifungal drug therapy,or the correction of predisposing factors,are usually required to obtain improvement.Infections present a therapeutic challenge,as they have intrinsic resistance to many antifungal agents,but voriconazole and posaconazole are good in vitro activity.The overall mortality was 22%and death was attributed to the infection in 46%of cases.Accurate diagnoses can be achieved through newer molecular biological techniques,and these can lead to appropriate management of infections due to this organism.Future studies should ideally aim to elucidate pathogenesis and determine more effective diagnoses and effective antifungal treatment.
文摘The coronavirus disease 2019(COVID-19)pandemic has caused detrimental effects on many aspects of healthcare practice.Screening programs for the commonest malignancies,namely colorectal cancer(CRC),breast cancer and cervical cancer have been discontinued or interrupted since the beginning of restriction measures aimed to limit transmission of the new coronavirus infection.Robust evidence exists in favour of the role of screening campaigns in reducing mortality from CRC.In fact,the majority of pre-malignant lesions of the colon and rectum can be diagnosed with colonoscopy and treated by endoscopic or surgical resection.Besides,colonoscopy screening allows the diagnosis of CRCs in their pre-clinical stage.Italy was one of the first European countries where a high level of COVID-19 infections and deaths was observed,and one of the first where lockdowns and strict measures were adopted to reduce the risk of COVID-19 diffusion among the population.A systematic review of the literature was performed,including the PubMed,Scopus,Web of Sciences,and Reference Citation Analysis databases,with the aim of critically evaluating the impact of the COVID-19 pandemic on CRC screening in Italy.We found that reduction of CRC screening activity surpassed 50%in most endoscopic units,with almost 600000 fewer CRC screening exams conducted in the first 5 mo of 2020 vs the same period of 2019.While the consequences of the discontinuation of endoscopy screening for the prognosis and mortality of CRC will be evident in the next few years,recent data confirm that CRC is currently treated at a more advanced stage than in the pre-COVID-19 era.Since delays in CRC prevention and early diagnosis may translate to increased CRC-specific mortality,world healthcare systems should adopt strategies to maintain the regularity of CRC screening during subsequent peaks of the COVID-19 pandemic,or future events that might hamper screening programs.
文摘The incidence of hepatocellular carcinoma(HCC)has been steadily rising,und-erscoring the need for a clear,stage-specific treatment approach.The Barcelona Clinic Liver Cancer(BCLC)staging system remains the most widely used frame-work for classifying HCC and guiding therapy.Among its classifications,the intermediate stage(BCLC-B)encompasses a highly heterogeneous patient popu-lation,with varying degrees of tumor burden and liver function.Traditionally,transarterial chemoembolization has been the standard treatment for this stage,based on earlier evidence.However,recent studies suggest that a subset of BCLC-B patients-particularly those with localized disease-may benefit more from liver resection.This review summarizes current treatment paradigms for BCLC-B HCC,explores emerging subclassifications within this group,and highlights evolving guidelines that support the selective use of surgery in appropriately chosen patients.
文摘Deep transcranial magnetic stimulation(DTMS)is a new non-invasive neuromodulation technique based on repetitive transcranial magnetic stimulation technology.The new H-coil has significant advantages in the treatment and mechanism research of psychiatric and neurological disorders.This is due to its deep stimulation site and wide range of action.This paper reviews the clinical progress of DTMS in psychiatric and neurological disorders such as Parkinson’s disease,Alzheimer’s disease,post-stroke motor dysfunction,aphasia,and other neurological disorders,as well as anxiety,depression,and schizophrenia.
文摘BACKGROUND Risk stratification for patients with gastric precancerous lesions for endoscopic surveillance remains controversial.AIM To analysis of patients having developed gastric adenocarcinoma during the period of follow-up.METHODS We conducted a retrospective study on patients having undergone upper endoscopy prior to the development of gastric adenocarcinoma. The presence and stage of precancerous lesions as well as subtype of intestinal metaplasia at the baseline endoscopy got evaluated. Literature mini-review was performed.RESULTS Out of 1681 subjects in the Biobank, gastric adenocarcinoma was detected in five cases in whom previous endoscopy data with biopsies either from the corpus or antral part were available. All of the patients had incomplete intestinal metaplasia during the baseline endoscopy;all three subjects in whom intestinal metaplasia subtyping was performed according to Filipe et al, had Type Ⅲ intestinal metaplasia. Two of the five cases had low Operative Link on Gastritis Assessment(OLGA) and Operative Link on Gastritis Intestinal Metaplasia Assessment(OLGIM) stages(Ⅰ-Ⅱ) at the baseline.CONCLUSION The presence of incomplete intestinal metaplasia, in particular, that of Type Ⅲ is a better predictor for gastric adenocarcinoma development than OLGA/OLGIM staging system. Subtyping of intestinal metaplasia have an important role in the risk stratification for surveillance decisions.
文摘Nonalcoholic fatty liver disease(NAFLD)is the most common chronic liver disease,leading to fibrosis,cirrhosis and hepatocellular carcinoma and also associated with increased cardiovascular disease mortality.The pathogenesis of NAFLD is not fully understood,although NAFLD is thought to be a hepatic form of metabolic syndrome.There is an increasing understanding of the role of microbiota disturbances in NAFLD pathogenesis,and as with many other conditions affecting the microbiota,NAFLD may be a novel risk factor for Clostridioides difficile(C.difficile)colonization(CDC)and C.difficile infection(CDI).CDI is an emerging nosocomial disease,and community-acquired cases of infection are growing,probably due to an increase in CDC rates.The association of NAFLD with CDI has been shown in only 4 studies to date,three of which included less than 1000 patients,although the frequency of NAFLD in these studies was observed in almost 20%of the total patient cohort.These data revealed that NAFLD is a risk factor for CDI development and,moreover,is a risk factor for intestinal complications of CDI.More studies are needed to investigate this association and move forward CDC and CDI screening efforts for this group of patients.
文摘The variability of vascular anatomy of the pancreas underlines the difficulty of its transplantation.Research regarding the consistency of anatomical variations shows splenic arterial dominance in most cases.This can significantly improve transplantation success.A systematic literature review was performed according to the quality standards described in the AMSTAR measurement tool and the PRISMA guidelines.We valuated existing literature regarding the vascularization and blood perfusion patterns of the pancreas in terms of dominance and variability.The collected data was independently analyzed by two researchers.Variance of vascular anatomy was seen to be underreported in literature,though significant findings have been included and discussed in this study,providing valuable insight into the dynamics of pancreatic perfusion and feasibility of transplantation on several different supplying arteries.The splenic artery(SA)has a high percentage of consistency in all found studies(over 90%).High frequency of anastomoses between arterial pools supplying the pancreas can mediate sufficient blood supply through a dominant vessel,such as the SA,which is present in most cases.Pancreatic transplantation with isolated SA blood supply can provide sufficient arterial perfusion of the pancreas for stable transplant viability due to high anatomical consistency of the SA and vast communications with other arterial systems.
文摘The coronavirus disease 2019(COVID-19)disease was first detected in December 2019 in Wuhan,China.This disease is currently one of the most important global health problems.The novel coronavirus COVID-19 is a respiratory illness,that has caused a deadly pandemic that is spreading rapidly around the world.It is not only a respiratory system virus that causes severe lung disease,but also a systemic disease agent that can affect all systems.People with COVID-19 disease usually have respiratory signs,however,the liver disorder is not an uncommon presentation.In addition,many studies around the world have revealed that the liver is injured to various degrees in patients with severe acute respiratory syndrome coronavirus 2 disease.This review mainly focuses on the impact of COVID-19 on Liver Injury at various ages.
