Animal models are necessary to investigate the pathogenic features underlying motor neuron degeneration and for therapeutic development in amyotrophic lateral sclerosis（ALS）. Measures of model validity allow for a c...Animal models are necessary to investigate the pathogenic features underlying motor neuron degeneration and for therapeutic development in amyotrophic lateral sclerosis（ALS）. Measures of model validity allow for a critical interpretation of results from each model and caution from over-interpretation of experimental models. Face and construct validity refer to the similarity in phenotype and the proposed causal factor to the human disease, respectively. More recently developed models are restricted by limited phenotype characterization, yet new models hold promise for novel disease insights, thus highlighting their importance. In this article, we evaluate the features of face and construct validity of our new zebrafish model of environmentally-induced motor neuron degeneration and discuss this in the context of current environmental and genetic ALS models, including C9 orf72, mutant Cu/Zn superoxide dismutase 1 and TAR DNA-binding protein 43 mouse and zebrafish models. In this mini-review, we discuss the pros and cons to validity criteria in each model. Our zebrafish model of environmentally-induced motor neuron degeneration displays convincing features of face validity with many hallmarks of ALS-like features, and weakness in construct validity. However, the value of this model may lie in its potential to be more representative of the pathogenic features underlying sporadic ALS cases, where environmental factors may be more likely to be involved in disease etiology than single dominant gene mutations. It may be necessary to compare findings between different strains and species modeling specific genes or environmental factors to confirm findings from ALS animal models and tease out arbitrary strain-and overexpression-specific effects.展开更多
Although mutations in the superoxide dismutase 1 gene account for only a minority of total amyotrophic lateral sclerosis cases,the discovery of this gene has been crucial for amyotrophic lateral sclerosis research.Sin...Although mutations in the superoxide dismutase 1 gene account for only a minority of total amyotrophic lateral sclerosis cases,the discovery of this gene has been crucial for amyotrophic lateral sclerosis research.Since the identification of superoxide dismutase 1 in 1993,the field of amyotrophic lateral sclerosis genetics has considerably widened,improving our understanding of the diverse pathogenic basis of amyotrophic lateral sclerosis.In this review,we focus on cognitive impairment in superoxide dismutase 1-amyotrophic lateral sclerosis patients.Literature has mostly reported that cognition remains intact in superoxide dismutase 1-amyotrophic lateral sclerosis patients,but recent reports highlight frontal lobe function frailty in patients carrying different superoxide dismutase 1-amyotrophic lateral sclerosis mutations.We thoroughly reviewed all the various mutations reported in the literature to contribute to a comprehensive database of superoxide dismutase 1-amyotrophic lateral sclerosis genotype-phenotype correlation.Such a resource could ultimately improve our mechanistic understanding of amyotrophic lateral sclerosis,enabling a more robust assessment of how the amyotrophic lateral sclerosis phenotype responds to different variants across genes,which is important for the therapeutic strategy targeting genetic mutations.Cognition in superoxide dismutase 1-amyotrophic lateral sclerosis deserves further longitudinal research since this peculiar frailty in patients with similar mutations can be conditioned by external factors,including environment and other unidentified agents including modifier genes.展开更多
Spinal cord injury （SCI） is a devastating condition that not only results in a loss of motor functions but also severe autonomic dysfunctions （Krassioukov and Claydon, 2006）. Autonomic dysreflexia （AD） is a life...Spinal cord injury （SCI） is a devastating condition that not only results in a loss of motor functions but also severe autonomic dysfunctions （Krassioukov and Claydon, 2006）. Autonomic dysreflexia （AD） is a life threatening episode of tran- sient hypertension that occurs up to 30x/day （1 Ix/day on average） in those with cervical or high thoracic SCI （Hubli et al., 2015）. Most common triggers of AD are from stimuli such as a full bowel and/or bladder, or sexual arousal （Teasell et al., 2000）. Penile vibrostimulation （PVS） is a clinical pro- cedure for sperm retrieval used for the purpose of family planning or fertility assessment that unfortunately iatrogenically induces episodes of AD （Elliott, 2006）. Recently, we published a clinical trial highlighting that prazosin may be a viable option for treating AD secondary to PVS （Phillips et al., 2014）.展开更多
BACKGROUND Bow hunter’s syndrome(BHS)is a rare but surgically treatable cause of vertebrobasilar insufficiency due to dynamic rotational occlusion of the vertebral artery.Typically,patients present with posterior cir...BACKGROUND Bow hunter’s syndrome(BHS)is a rare but surgically treatable cause of vertebrobasilar insufficiency due to dynamic rotational occlusion of the vertebral artery.Typically,patients present with posterior circulation transient ischaemic symptoms such as presyncope,syncope,vertigo,diplopia,and horizontal nystagmus,but irreversible deficits,including medullary and cerebellar infarctions,have also been described.CASE SUMMARY A 70-year-old patient presented an acute onset of vertigo and gait instability triggered by right head rotation.His medical history included previous episodes of unilateral left neck and occipital pain followed by light-headedness,sweating,and blurred vision when turning his head,and these episodes were associated with severe degenerative changes in the atlanto-dens and left atlanto-axial facet joints and right rotation of the C2 cervical vertebrae.Brain magnetic resonance imaging revealed the presence of acute bilateral cerebellar ischaemic lesions,while static vascular imaging did not reveal any vertebral artery abnormalities.Dynamic ultrasonography and angiography were performed and confirmed the presence of a dynamic occlusion of the vertebral artery V3-V4 segment when the head was rotated to the right secondary to left C1-C2 bone spur compression.Surgical decompression led to complete resolution of paroxysmal symptoms without neurological sequelae.CONCLUSION BHS should be considered in cases of repeated posterior circulation transient ischaemic attack or ischaemic stroke,particularly when associated with high cervical spine abnormalities.展开更多
Research has shown that cells from adult fat tissue can effect long-term blood reconstitution. Fat-derived multipotentiality was ascribed to CD34+ perivascular populations from its prominent microvasculature, that rep...Research has shown that cells from adult fat tissue can effect long-term blood reconstitution. Fat-derived multipotentiality was ascribed to CD34+ perivascular populations from its prominent microvasculature, that represent mostly non-hemogenic, mesenchymal cells, although this tissue contains a CD34+45+ subset committed to a hemogenic fate. Here, in order to analyze cell subsets presenting hemogenic capabilities within fat, CD133/1+ and pericytes, the latter defined by CD140b (PDGFRb, Platelet-Derived Growth Factor Receptor Beta) expression, were immunomagnetically selected from stromal-vascular fractions (SVF). In Vitro Colony Forming Unit (CFU) assays were negative for CD140b+ pericytes and positive for CD133/1+ cells when a prolonged CFU assay was performed, revealing fat as another store of primitive progenitors that retain hemogenic potential.展开更多
The tumor microenvironment(TME)constitutes a complex structure comprising different cell types and soluble factors that surround the tumor and promote its progression.Primarily for its pivotal role in malignant growth...The tumor microenvironment(TME)constitutes a complex structure comprising different cell types and soluble factors that surround the tumor and promote its progression.Primarily for its pivotal role in malignant growth,TME has become a potential therapeutic objective for developing new targeted therapy and a marker for assessing therapeutic response.In intrahepatic cholangiocarcinoma(iCCA),the second most common primary liver malignancy,TME has also gained a central role in understanding the mechanisms underlying tumor progression.In this review,we focused on the role of angiogenic factors and their pathway in iCCA and analyzed possible therapeutic and prognostic implications.展开更多
The high mutation rate of SARS-CoV-2 leads to the emergence of multiple variants,some of which are resistant to vaccines and drugs targeting viral elements.Targeting host dependency factors,e.g.cellular proteins requi...The high mutation rate of SARS-CoV-2 leads to the emergence of multiple variants,some of which are resistant to vaccines and drugs targeting viral elements.Targeting host dependency factors,e.g.cellular proteins required for viral replication,would help prevent the development of resistance.However,it remains unclear whether different SARS-CoV-2 variants induce conserved cellular responses and exploit the same core host factors.To this end,we compared three variants of concern and found that the host transcriptional response was conserved,differing only in kinetics and magnitude.Clustered regularly interspaced short palindromic repeats screening identified host genes required for each variant during infection.Most of the genes were shared by multiple variants.We validated our hits with small molecules and repurposed the US Food and Drug Administration-approved drugs.All the drugs were highly active against all the tested variants,including new variants that emerged during the study(Delta and Omicron).Mechanistically,we identified reactive oxygen species production as a key step in early viral replication.Antioxidants such as N-acetyl cysteine(NAC)were effective against all the variants in both human lung cells and a humanized mouse model.Our study supports the use of available antioxidant drugs,such as NAC,as a general and effective anti-COVID-19 approach.展开更多
Dear Editor Aberrant gene expression sustains massive proliferation and stress adaptation under the regulation of oncogenic transcription factors(TFs)whose binding across the genome orchestrates in space and time tran...Dear Editor Aberrant gene expression sustains massive proliferation and stress adaptation under the regulation of oncogenic transcription factors(TFs)whose binding across the genome orchestrates in space and time transcription.Transcriptional dependency defines the addiction of cancer cells to TFs on top of the regulatory hierarchy governing cancer dysregulated programs[1].These factors and their dependent mechanisms are an attractive and unexplored reservoir of potential targets for new anticancer drugs.Still,while the transcriptional landscape of many cancer-supportive TFs has been revealed,this information remains purely descriptive and confined to in vitro models.To foster transferability,new approaches that integrate clinical data into the transcriptional networks are needed.展开更多
This study presents the novel Traction-Free Posture Orthosis,designed to address wrist stiffness without the use of traditional traction methods.The orthosis employs a velcro system to stabilize the position of the wr...This study presents the novel Traction-Free Posture Orthosis,designed to address wrist stiffness without the use of traditional traction methods.The orthosis employs a velcro system to stabilize the position of the wrist in flexion or extension,thereby avoiding the compression and rotational disadvantages associated with non-perpendicular traction forces.Triangular-shaped cuts in the brace allow for plastic material flexibility,ensuring movement and comfort.Significant is the absence of a traction strap,which traditionally reduces the support surface and could create pressure points leading to patient discomfort or treatment rejection.The design facilitates a wide contact surface with the hand,optimal load distribution,and the capacity to adjust dual traction straps independently,adapting to the natural wrist movement.This single-piece base orthosis offers a stable,cost-effective,and patientfriendly alternative to conventional splints.However,patients with stiffness in both flexion and extension may require two separate orthoses,potentially increasing costs and patient inconvenience.Overall,the Traction-Free Posture Orthosis represents an innovative step in wrist rehabilitation,providing a quick-to-construct,easy-to-wear solution with the promise of enhanced patient compliance and comfort.展开更多
We read with pleasure papers by Cai et al. and Jia et al. published in HepatoBiliary Surgery and Nutrition, 2018, Volume 7, Issue 2 and 4, respectively (1,2). Both papers introduced comprehensive up-to-date literature...We read with pleasure papers by Cai et al. and Jia et al. published in HepatoBiliary Surgery and Nutrition, 2018, Volume 7, Issue 2 and 4, respectively (1,2). Both papers introduced comprehensive up-to-date literature reviews on indications and patient selection, surgical instruments, techniques, and outcomes of laparoscopic liver resections (LLRs) (1,2). Papers mentioned final statements by 2008 Louisville Statement and 2014 Morioka Consensus Conference (1,2). They stressed LLR non-inferiority to open procedures, in both minor and major liver resections as far as oncological and intraoperative/perioperative outcomes are concerned: reduced blood loss, lower postoperative morbidity and shorter length of hospitalization (1,2). Such results were corroborated by recent meta-analyses (3,4). Furthermore, some previous limitations for LLR look like they have been recently overcome (1-5). For example, tumor size, patient's old age and high BMI are no longer limitations for LLR, as Southampton Consensus guidelines suggested (5). Likewise, cirrhosis has been suggested as a further indication of LLR in highly selected patients with hepatocellular carcinoma and where it was performed by experienced surgeons (1-5).展开更多
We really appreciated Geramizadeh, " Bile spillage and incidental gall bladder adenocarcinoma ", and Sandstrom et al. ,"Bile spillage should be avoided in elective cholecystectomy " (1,2). Both pap...We really appreciated Geramizadeh, " Bile spillage and incidental gall bladder adenocarcinoma ", and Sandstrom et al. ,"Bile spillage should be avoided in elective cholecystectomy " (1,2). Both papers have been recently published in HepatoBiliary Surgery and Nutrition, 2019 (1,2). Starting from an analysis of the recent paper by Horkoff et al. "Adverse outcomes after bile spillage in incidental gall bladder cancer " in Annals of Surgery April 2019, they introduced a comprehensive discussion about epidemiology, diagnosis, therapy, prognostic factors and outcomes of incidental gallbladder cancer (1-3). They analyzed the possible risks related to bile spillage after cholecystectomy, in particular (1,2).展开更多
Aim:In this systematic review,guidelines on non-alcoholic fatty liver disease(NAFLD)were evaluated,aiming at a guideline synthesis focusing on diagnosis and staging.Methods:A systematic literature search was conducted...Aim:In this systematic review,guidelines on non-alcoholic fatty liver disease(NAFLD)were evaluated,aiming at a guideline synthesis focusing on diagnosis and staging.Methods:A systematic literature search was conducted on any relevant database or institutional website to find guidelines on NAFLD assessment intended for clinical use on humans,in English,published from January 2010 to August 2020.Included guidelines were appraised using the AGREE Ⅱ Instrument;those with higher scores and intended for use in adult patients were included in a comparative analysis.Results:Fourteen guidelines were included in the systematic review,eight of which reached an AGREE Ⅱ score sufficiently high to be recommended for clinical use,of which one developed for pediatric patients only.British and North American guidelines received the highest scores.Most guidelines recommend a screening or case-finding approach in patients with metabolic risk factors who are at increased risk of steatohepatitis or fibrosis.Ultrasound is mostly recommended to confirm steatosis,while the presence of metabolic syndrome,liver function tests,fibrosis scores,and elastographic techniques may help in selecting high-risk patients to be referred to the hepatologist,who may consider liver biopsy,although referral criteria for liver biopsy are not clearly defined.Most guidelines identify the development of noninvasive tests to replace liver biopsy as a research priority.Conclusion:Several high-quality guidelines exist for NAFLD assessment,with no complete agreement on whether to screen high-risk patients and on the tests and biomarkers suggested to stratify patients and select those to be referred to liver biopsy.展开更多
基金supported by grants from RG is an awardee of The Chinese Scholarship Council(CSC)partially supported by grants from The Canadian Institutes of Health Research to JH+1 种基金The National Basic Research Program of China(2011CB9107040)The National Natural Science Foundation of China(30973289,81272971)~~
基金supported by a grant from Estate of Luther Allyn Shourds Dean,No.20R17162(to CAS)
文摘Animal models are necessary to investigate the pathogenic features underlying motor neuron degeneration and for therapeutic development in amyotrophic lateral sclerosis（ALS）. Measures of model validity allow for a critical interpretation of results from each model and caution from over-interpretation of experimental models. Face and construct validity refer to the similarity in phenotype and the proposed causal factor to the human disease, respectively. More recently developed models are restricted by limited phenotype characterization, yet new models hold promise for novel disease insights, thus highlighting their importance. In this article, we evaluate the features of face and construct validity of our new zebrafish model of environmentally-induced motor neuron degeneration and discuss this in the context of current environmental and genetic ALS models, including C9 orf72, mutant Cu/Zn superoxide dismutase 1 and TAR DNA-binding protein 43 mouse and zebrafish models. In this mini-review, we discuss the pros and cons to validity criteria in each model. Our zebrafish model of environmentally-induced motor neuron degeneration displays convincing features of face validity with many hallmarks of ALS-like features, and weakness in construct validity. However, the value of this model may lie in its potential to be more representative of the pathogenic features underlying sporadic ALS cases, where environmental factors may be more likely to be involved in disease etiology than single dominant gene mutations. It may be necessary to compare findings between different strains and species modeling specific genes or environmental factors to confirm findings from ALS animal models and tease out arbitrary strain-and overexpression-specific effects.
文摘Although mutations in the superoxide dismutase 1 gene account for only a minority of total amyotrophic lateral sclerosis cases,the discovery of this gene has been crucial for amyotrophic lateral sclerosis research.Since the identification of superoxide dismutase 1 in 1993,the field of amyotrophic lateral sclerosis genetics has considerably widened,improving our understanding of the diverse pathogenic basis of amyotrophic lateral sclerosis.In this review,we focus on cognitive impairment in superoxide dismutase 1-amyotrophic lateral sclerosis patients.Literature has mostly reported that cognition remains intact in superoxide dismutase 1-amyotrophic lateral sclerosis patients,but recent reports highlight frontal lobe function frailty in patients carrying different superoxide dismutase 1-amyotrophic lateral sclerosis mutations.We thoroughly reviewed all the various mutations reported in the literature to contribute to a comprehensive database of superoxide dismutase 1-amyotrophic lateral sclerosis genotype-phenotype correlation.Such a resource could ultimately improve our mechanistic understanding of amyotrophic lateral sclerosis,enabling a more robust assessment of how the amyotrophic lateral sclerosis phenotype responds to different variants across genes,which is important for the therapeutic strategy targeting genetic mutations.Cognition in superoxide dismutase 1-amyotrophic lateral sclerosis deserves further longitudinal research since this peculiar frailty in patients with similar mutations can be conditioned by external factors,including environment and other unidentified agents including modifier genes.
基金AAP is supported by the Heart and Stroke Foundation of Canadathe Michael Smith Foundation for Health Research+3 种基金AVK is supported by the Paralyzed Veterans of Americathe Craig Neilson Foundationthe Canadian Institute of Health Researchthe Heart and Stroke Foundation of Canada
文摘Spinal cord injury （SCI） is a devastating condition that not only results in a loss of motor functions but also severe autonomic dysfunctions （Krassioukov and Claydon, 2006）. Autonomic dysreflexia （AD） is a life threatening episode of tran- sient hypertension that occurs up to 30x/day （1 Ix/day on average） in those with cervical or high thoracic SCI （Hubli et al., 2015）. Most common triggers of AD are from stimuli such as a full bowel and/or bladder, or sexual arousal （Teasell et al., 2000）. Penile vibrostimulation （PVS） is a clinical pro- cedure for sperm retrieval used for the purpose of family planning or fertility assessment that unfortunately iatrogenically induces episodes of AD （Elliott, 2006）. Recently, we published a clinical trial highlighting that prazosin may be a viable option for treating AD secondary to PVS （Phillips et al., 2014）.
文摘BACKGROUND Bow hunter’s syndrome(BHS)is a rare but surgically treatable cause of vertebrobasilar insufficiency due to dynamic rotational occlusion of the vertebral artery.Typically,patients present with posterior circulation transient ischaemic symptoms such as presyncope,syncope,vertigo,diplopia,and horizontal nystagmus,but irreversible deficits,including medullary and cerebellar infarctions,have also been described.CASE SUMMARY A 70-year-old patient presented an acute onset of vertigo and gait instability triggered by right head rotation.His medical history included previous episodes of unilateral left neck and occipital pain followed by light-headedness,sweating,and blurred vision when turning his head,and these episodes were associated with severe degenerative changes in the atlanto-dens and left atlanto-axial facet joints and right rotation of the C2 cervical vertebrae.Brain magnetic resonance imaging revealed the presence of acute bilateral cerebellar ischaemic lesions,while static vascular imaging did not reveal any vertebral artery abnormalities.Dynamic ultrasonography and angiography were performed and confirmed the presence of a dynamic occlusion of the vertebral artery V3-V4 segment when the head was rotated to the right secondary to left C1-C2 bone spur compression.Surgical decompression led to complete resolution of paroxysmal symptoms without neurological sequelae.CONCLUSION BHS should be considered in cases of repeated posterior circulation transient ischaemic attack or ischaemic stroke,particularly when associated with high cervical spine abnormalities.
文摘Research has shown that cells from adult fat tissue can effect long-term blood reconstitution. Fat-derived multipotentiality was ascribed to CD34+ perivascular populations from its prominent microvasculature, that represent mostly non-hemogenic, mesenchymal cells, although this tissue contains a CD34+45+ subset committed to a hemogenic fate. Here, in order to analyze cell subsets presenting hemogenic capabilities within fat, CD133/1+ and pericytes, the latter defined by CD140b (PDGFRb, Platelet-Derived Growth Factor Receptor Beta) expression, were immunomagnetically selected from stromal-vascular fractions (SVF). In Vitro Colony Forming Unit (CFU) assays were negative for CD140b+ pericytes and positive for CD133/1+ cells when a prolonged CFU assay was performed, revealing fat as another store of primitive progenitors that retain hemogenic potential.
基金supported by Associazione Italiana sulla Ricerca sul Cancro(AIRCGrant No.IG 2020-ID.24858 project-P.I.Villa Erica).
文摘The tumor microenvironment(TME)constitutes a complex structure comprising different cell types and soluble factors that surround the tumor and promote its progression.Primarily for its pivotal role in malignant growth,TME has become a potential therapeutic objective for developing new targeted therapy and a marker for assessing therapeutic response.In intrahepatic cholangiocarcinoma(iCCA),the second most common primary liver malignancy,TME has also gained a central role in understanding the mechanisms underlying tumor progression.In this review,we focused on the role of angiogenic factors and their pathway in iCCA and analyzed possible therapeutic and prognostic implications.
基金supported by the CaRiPaRo Foundation(NewTarCoV2)the Ministry of Education,University and Research(PRIN-2020KSY3KL)+13 种基金supported by the Telethon Foundation Core Grant,European Research Council(ERC)(CellKarma)Regione Campania(PO-FESR 2014-2020,PO-FESR 2014-2020)Italian Ministry of Health(Piano Operativo Salute Traiettoria 3,‘Genomed’).supported by the Giovanni Armenise-Harvard Foundation,the Telethon Foundation(TCP13013)ERC(ERC Starting Grant,‘MetEpiStem’)supported by ERC(ERC Consolidator 615879)the Bill and Melinda Gates Foundation(OPP1035881 and OPP1097238)the Italian Foundation for Cancer Research(AIRC 21850)the Collaborative Center for XDP at Massachusetts General Hospital(239295)supported by the Italian Foundation for Cancer Research(AIRC-MFAG 25745)University of Padua(STARS Consolidator Grant,‘EMERALD’)supported by the Italian Foundation for Cancer Research(AIRC 2135)Italian Ministry of Health(RCR-201923669115,NET-201602361632)supported by the EVA-GLOBAL project that has received funding from the European Union’s Horizon 2020 Research and Innovation Programme under grant agreement number 871029EVA-GLOBAL provided access to SARS-CoV-2 Alpha and Delta isolates(human nCoV19 isolate/England/MIG457/2020 and hCoV-19/Netherlands/NH-RIVM-27142/2021_P2).
文摘The high mutation rate of SARS-CoV-2 leads to the emergence of multiple variants,some of which are resistant to vaccines and drugs targeting viral elements.Targeting host dependency factors,e.g.cellular proteins required for viral replication,would help prevent the development of resistance.However,it remains unclear whether different SARS-CoV-2 variants induce conserved cellular responses and exploit the same core host factors.To this end,we compared three variants of concern and found that the host transcriptional response was conserved,differing only in kinetics and magnitude.Clustered regularly interspaced short palindromic repeats screening identified host genes required for each variant during infection.Most of the genes were shared by multiple variants.We validated our hits with small molecules and repurposed the US Food and Drug Administration-approved drugs.All the drugs were highly active against all the tested variants,including new variants that emerged during the study(Delta and Omicron).Mechanistically,we identified reactive oxygen species production as a key step in early viral replication.Antioxidants such as N-acetyl cysteine(NAC)were effective against all the variants in both human lung cells and a humanized mouse model.Our study supports the use of available antioxidant drugs,such as NAC,as a general and effective anti-COVID-19 approach.
基金Fondazione Italiana per la Ricerca sul Cancro(project code:AIRC IG21772).
文摘Dear Editor Aberrant gene expression sustains massive proliferation and stress adaptation under the regulation of oncogenic transcription factors(TFs)whose binding across the genome orchestrates in space and time transcription.Transcriptional dependency defines the addiction of cancer cells to TFs on top of the regulatory hierarchy governing cancer dysregulated programs[1].These factors and their dependent mechanisms are an attractive and unexplored reservoir of potential targets for new anticancer drugs.Still,while the transcriptional landscape of many cancer-supportive TFs has been revealed,this information remains purely descriptive and confined to in vitro models.To foster transferability,new approaches that integrate clinical data into the transcriptional networks are needed.
文摘This study presents the novel Traction-Free Posture Orthosis,designed to address wrist stiffness without the use of traditional traction methods.The orthosis employs a velcro system to stabilize the position of the wrist in flexion or extension,thereby avoiding the compression and rotational disadvantages associated with non-perpendicular traction forces.Triangular-shaped cuts in the brace allow for plastic material flexibility,ensuring movement and comfort.Significant is the absence of a traction strap,which traditionally reduces the support surface and could create pressure points leading to patient discomfort or treatment rejection.The design facilitates a wide contact surface with the hand,optimal load distribution,and the capacity to adjust dual traction straps independently,adapting to the natural wrist movement.This single-piece base orthosis offers a stable,cost-effective,and patientfriendly alternative to conventional splints.However,patients with stiffness in both flexion and extension may require two separate orthoses,potentially increasing costs and patient inconvenience.Overall,the Traction-Free Posture Orthosis represents an innovative step in wrist rehabilitation,providing a quick-to-construct,easy-to-wear solution with the promise of enhanced patient compliance and comfort.
基金We thank Dr. Daniela Masi (AUSL-IRCCS di Reggio Emilia) for support in English editing.
文摘We read with pleasure papers by Cai et al. and Jia et al. published in HepatoBiliary Surgery and Nutrition, 2018, Volume 7, Issue 2 and 4, respectively (1,2). Both papers introduced comprehensive up-to-date literature reviews on indications and patient selection, surgical instruments, techniques, and outcomes of laparoscopic liver resections (LLRs) (1,2). Papers mentioned final statements by 2008 Louisville Statement and 2014 Morioka Consensus Conference (1,2). They stressed LLR non-inferiority to open procedures, in both minor and major liver resections as far as oncological and intraoperative/perioperative outcomes are concerned: reduced blood loss, lower postoperative morbidity and shorter length of hospitalization (1,2). Such results were corroborated by recent meta-analyses (3,4). Furthermore, some previous limitations for LLR look like they have been recently overcome (1-5). For example, tumor size, patient's old age and high BMI are no longer limitations for LLR, as Southampton Consensus guidelines suggested (5). Likewise, cirrhosis has been suggested as a further indication of LLR in highly selected patients with hepatocellular carcinoma and where it was performed by experienced surgeons (1-5).
文摘We really appreciated Geramizadeh, " Bile spillage and incidental gall bladder adenocarcinoma ", and Sandstrom et al. ,"Bile spillage should be avoided in elective cholecystectomy " (1,2). Both papers have been recently published in HepatoBiliary Surgery and Nutrition, 2019 (1,2). Starting from an analysis of the recent paper by Horkoff et al. "Adverse outcomes after bile spillage in incidental gall bladder cancer " in Annals of Surgery April 2019, they introduced a comprehensive discussion about epidemiology, diagnosis, therapy, prognostic factors and outcomes of incidental gallbladder cancer (1-3). They analyzed the possible risks related to bile spillage after cholecystectomy, in particular (1,2).
文摘Aim:In this systematic review,guidelines on non-alcoholic fatty liver disease(NAFLD)were evaluated,aiming at a guideline synthesis focusing on diagnosis and staging.Methods:A systematic literature search was conducted on any relevant database or institutional website to find guidelines on NAFLD assessment intended for clinical use on humans,in English,published from January 2010 to August 2020.Included guidelines were appraised using the AGREE Ⅱ Instrument;those with higher scores and intended for use in adult patients were included in a comparative analysis.Results:Fourteen guidelines were included in the systematic review,eight of which reached an AGREE Ⅱ score sufficiently high to be recommended for clinical use,of which one developed for pediatric patients only.British and North American guidelines received the highest scores.Most guidelines recommend a screening or case-finding approach in patients with metabolic risk factors who are at increased risk of steatohepatitis or fibrosis.Ultrasound is mostly recommended to confirm steatosis,while the presence of metabolic syndrome,liver function tests,fibrosis scores,and elastographic techniques may help in selecting high-risk patients to be referred to the hepatologist,who may consider liver biopsy,although referral criteria for liver biopsy are not clearly defined.Most guidelines identify the development of noninvasive tests to replace liver biopsy as a research priority.Conclusion:Several high-quality guidelines exist for NAFLD assessment,with no complete agreement on whether to screen high-risk patients and on the tests and biomarkers suggested to stratify patients and select those to be referred to liver biopsy.
