Nuove frontiere nel trattamento endoscopico delle complicanze locali della pancreatite: studio bicentrico su Lumen Apposing Metal Stent (LAMS)

La pancreatite è una patologia caratterizzata da un processo infiammatorio con carattere acuto o cronico, patogenesi parzialmente oscura, eziologia variegata e complicanze che possono aggravare drasticamente il quadro clinico dei pazienti. I progressi tecnologici nell'ambito dell’endoscopia interventistica hanno portato al concepimento di un nuova tipologia di stent per il trattamento di raccolte fluide pancreatiche: Lumen Apposing Metal Stent(LAMS). Lo studio di tesi, dopo una prima parte di ricerca bibliografica sull'argomento, espone i risultati di un'indagine bicentrica condotta dalla SOD Endoscopia interventistica e pediatrica dell’AOUP e dall’Endoscopia digestiva, Dipartimento di servizi diagnostici e terapeutici, dell’IRCCS-ISMETT di Palermo. Pancreatitis is a pathology characterized by an inflammatory process with acute or chronic character, partially obscure pathogenesis, variegated etiology and complications that can drastically aggravate the clinical outcome of patients. The technological development in the field of interventional endoscopy has led to a new type of stent for the treatment of pancreatic fluid collections: Lumen Apposing Metal Stent (LAMS) This study, after the first part of bibliographical research on the subject, exposes the results of a bicentric experimental survey conducted by "SOD Endoscopia interventistica e pediatrica of the AOUP" and "Endoscopy Service, Department of Diagnostic and Therapeutic Services, IRCCS-ISMETT, Palermo"

Precision Endoscopy in Peroral Myotomies for Motility Disorders of the Upper Gastrointestinal Tract: Current Insights and Prospective Avenues—A Comprehensive Review

Our review delves into the realm of peroral endoscopic myotomies (POEMs) in the upper gastrointestinal tract (UGT). In recent years, POEMs have brought about a revolution in the treatment of UGT motility disorders. Esophageal POEM, the first to be introduced, has now been validated as the primary treatment for achalasia. Subsequently developed, G-POEM displays promising results in addressing refractory gastroparesis. Over time, multiple endoscopic myotomy techniques have emerged for the treatment of Zenker’s diverticulum, including Z-POEM, POES, and hybrid approaches. Despite the well-established efficacy outcomes, new challenges arise in the realm of POEMs in the UGT. For esophageal POEM, the future scenario lies in customizing the myotomy extent to the minimum necessary, while for G-POEM, it involves identifying patients who can optimally benefit from the treatment. For ZD, it is crucial to validate an algorithm that considers various myotomy options according to the diverticulum’s size and in relation to individual patients. These challenges align with the concept of precision endoscopy, personalizing the technique for each subject. Within our text, we comprehensively examine each myotomy technique, analyzing indications, outcomes, and adverse events. Additionally, we explore the emerging challenges posed by myotomies within the context of the evolving field of precision endoscopy

Synthesis, properties, and some rhodium, iridium, and platinum complexes of a series of bulky m-terphenylphosphine ligands

A series of sterically demanding aryl phosphine ligands (L) bearing terphenyl substituents, PRAr′ (R = hydrocarbyl, Ar′ = 2,6-diarylphenyl radical) has been prepared and characterized. The stability of these ligands towards oxidation in the air has been tested, and theoretical and experimental studies aimed to provide information on their electronic and steric properties have been performed. Treatment of the metal dimers [MCl(COD)](M = Rh, Ir; COD = 1,5-cyclooctadiene) with ligands PMeAr(L1) and PMeAr(L5), in a 1:1 metal:ligand ratio, afforded the expected square-planar 16-electron complexes [MCl(COD)(PMeAr)] and [MCl(COD)(PMeAr)], respectively. These compounds were readily converted into the corresponding dicarbonyl derivatives, [MCl(CO)(PMeAr)] and [MCl(CO)(PMeAr)], respectively. While the expected κ-P coordination mode of the PRAr′ ligands is found for these rhodium and iridium species, the mononuclear Pt(II) derivative obtained by reaction of PtClwith PMeArhas composition [PtCl(PMeAr)], and exhibits a bidentate κ-P, η-arene coordination mode involving one of the ipso carbon atoms of a flanking terphenyl aryl ring. The corresponding carbonyl compound [PtCl(CO)(PMeAr)], was generated under a CO atmosphere and exhibits κ-P coordination mode.Peer Reviewe

Pain assessment and management in Italian Haemophilia Centres

Although the widespread use of factor VIII/IX replacement therapy has significantly reduced the severity of arthropathy in persons with haemophilia (PWH), some develop degenerative joint changes, associated with significant pain. The aim of this survey was to investigate the management and perception of pain among Italian physicians who treat PWH