Search Results (52)

Robotic pancreaticoduodenectomy (RPD) has emerged as a viable alternative to open and laparoscopic approaches, offering potential advantages in precision and dexterity. However, its complexity and lack of standardization remain as barriers to widespread adoption. We present a step-by-step surgical approach to RPD, emphasizing key technical strategies to enhance safety, efficiency, and reproducibility. Our technique is structured into defined surgical steps, facilitating learning curve optimization and intraoperative consistency. Key refinements include an optimized trocar placement, the strategic suspension of vascular structures, and specific reconstructive techniques to reduce the operative time and improve surgical ergonomics. These improvements may contribute to a reduction in perioperative morbidity and procedural standardization. Standardizing RPD through defined surgical steps and structured learning pathways may improve its feasibility, safety, and broader adoption. Further studies are needed to validate these strategies in high-volume centers. Full article

Recently, the “epithelial barrier hypothesis” has been proposed as a key factor in the development of allergic diseases, such as food allergies. Harmful environmental factors can damage epithelial barriers, with detrimental effects on the host immune response and on the local microbial equilibrium, resulting in chronic mucosal inflammation that perpetuates the dysfunction of the epithelial barrier. The increased epithelial permeability allows allergens to access the submucosae, leading to an imbalance between type 1 T-helper (Th1) and type 2 T-helper (Th2) inflammation, with a predominant Th2 response that is the key factor in food allergy development. In this article on the state of the art, we review scientific evidence on the “epithelial barrier hypothesis”, with a focus on food allergies. We describe how loss of integrity of the skin and intestinal epithelial barrier and modifications in gut microbiota composition can contribute to local inflammatory changes and immunological unbalance that can lead to the development of food allergies. Full article

Background: Migraine, a prevalent neurovascular disorder, affects millions globally and is associated with significant morbidity. Emerging evidence suggests a crucial role of the gut microbiota and adipose tissue in the modulation of migraine pathophysiology, particularly through mechanisms involving neuroinflammation and metabolic regulation. Material and Methods: A narrative review of the literature from 2000 to 2024 was conducted using the PubMed database. Studies addressing the relationships between microbiota, adipose tissue, and migraine—including dietary interventions and their impact—were analyzed. Results: The findings highlight a bidirectional gut–brain axis, with gut microbiota influencing neuroinflammation via metabolites such as short-chain fatty acids (SCFAs). Obesity exacerbates migraine severity through chronic inflammation and the dysregulation of adipocytokines like leptin and adiponectin. Dietary patterns, such as low glycemic index diets and Mediterranean diets, and the use of prebiotics, probiotics, and postbiotics show potential in migraine management. Conclusions: This review underscores the need for integrative approaches targeting the microbiota–gut–brain axis and adipose tissue in migraine therapy. Future studies should explore longitudinal effects and personalized interventions to optimize outcomes. Full article

Parkinson’s disease (PD) is a progressive neurodegenerative disorder that affects over 1% of population over age 60. It is defined by motor and nonmotor symptoms including a spectrum of cognitive impairments known as Parkinson’s disease dementia (PDD). Currently, the only US Food and Drug Administration-approved treatment for PDD is rivastigmine, which inhibits acetylcholinesterase and butyrylcholinesterase increasing the level of acetylcholine in the brain. Due to its limited efficacy and side effect profile, rivastigmine is often not prescribed, leaving patients with no treatment options. PD has several derangements in neurotransmitter pathways (dopaminergic neurons in the nigrostriatal pathway, kynurenine pathway (KP), acetylcholine, α7 nicotinic receptor, and N-methyl-D-aspartate (NMDA) receptors) and rivastigmine is only partially effective as it only targets one pathway. Kynurenic acid (KYNA), a metabolite of tryptophan metabolism, affects the pathophysiology of PDD in multiple ways. Both galantamine (α7 nicotinic receptor) and memantine (antagonist of the NMDA subtype of the glutamate receptor) are KYNA modulators. When used in combination, they target multiple pathways. While randomized controlled trials (RCTs) with each drug alone for PD have failed, the combination of galantamine and memantine has demonstrated a synergistic effect on cognitive enhancement in animal models. It has therapeutic potential that has not been adequately assessed, warranting future randomized controlled trials. In this review, we summarize the KYNA-centric model for PD pathophysiology and discuss how this treatment combination is promising in improving cognitive function in patients with PDD through its action on KYNA. Full article

Golden tomato (GT), harvested at the veraison stage, has gained attention due to its rich content of bioactive compounds and potential health benefits. Previous studies have highlighted GT’s antioxidant properties and its positive effects on metabolic syndrome (MetS), a condition characterized by obesity, dyslipidemia, and oxidative stress. This study investigates for the first time a derivative from GT, i.e., the juice (GTJ), which could be a potential candidate for development as a functional food. We first characterized GT juice, identifying 9-oxo-10(E),12(E)-octadecadienoic (9-oxo-10(E),12(E)-ODA) fatty acid, a known peroxisome proliferator-activated receptor alpha (PPAR-α) agonist, using High-Performance Liquid Chromatography (HPLC)–mass spectrometry. Then, using a high-fat-diet (HFD) rat model, we assessed the impact of daily GT juice supplementation in addressing MetS. We outlined that GTJ improved body weight and leptin-mediated food intake. Moreover, it ameliorated glucose tolerance, lipid profile, systemic redox homeostasis, hepatic oxidative stress, and steatosis in HFD rats. Furthermore, GT juice enhances the hepatic transcription of PPAR-α, thus putatively promoting fatty acid oxidation and lipid metabolism. These findings suggest that GT juice mitigates lipidic accumulation and putatively halters oxidative species at the hepatic level through PPAR-α activation. Our study underscores the protective effects of GT juice against MetS, highlighting its future potential as a nutraceutical for improving dysmetabolism and associated alterations. Full article

Background/Objectives: The literature reports that emotional disorders in asthmatic children and their parents may affect asthma control. This research explores the baseline psychological well-being of asthmatic children and their mothers’ and fathers’ psychological functioning, focusing on the influence of the parents’ anxiety and separation anxiety on children’s asthma. Methods: In this cross-sectional study, we enrolled children with non-severe asthma and their parents, and a group of healthy children and their parents. The asthmatic children underwent anamnestic investigation, including asthma control and spirometry. Then, both the asthmatic and control triads filled a survey assessing their psychological functioning. Results: Among the 40 asthmatic children enrolled (8–18 years old), most had good clinical control maintained with GINA (Global Initiative for Asthma) therapy step 1–2 (14 patients, 35%) or step 3–4 (26 patients, 65%); 12 patients (30%) had at least one steroid course in the year before enrollment. They exhibited normal psychological adjustment but elevated levels of general (U = 179,500; p < 0.001) and state anxiety (U = 170,000; p < 0.001) compared to healthy peers. Additionally, the asthmatic children’s mothers displayed higher levels of separation anxiety compared to the fathers (t = −2.865, p = 0.006). Increased separation anxiety in the mothers corresponded to a history of at least one exacerbation in the previous year. Conclusions: The asthmatic children exhibited normal psychological adjustment with higher general and state anxiety. Also, their mothers showed greater levels of separation anxiety compared to their fathers. Lastly, higher mothers’ separation anxiety corresponded to a history of at least one exacerbation in the previous year. The influence of the parents’ psychological well-being on the children’s asthma control was previously unexplored. Full article

Mono- and binuclear Cu(I) complexes were isolated employing 2,1,3-benzoselenadiazole (BSeD) as the N-donor ligand, and triphenylphosphine or bis[(2-diphenylphosphino)phenyl] ether (DPEphos) as P-donors. Then, ⁷⁷Se NMR was measured for the free ligand and the corresponding Cu(I) derivatives, and the related signal was downshifted by 12.86 ppm in the case of [Cu(BSeD)(PPh₃)₂(ClO₄)], and around 15 ppm for the binuclear species. The structure of [Cu(BSeD)(PPh₃)₂(ClO₄)] and [Cu₂(μ₂-BSeD)(DPEphos)₂(ClO₄)₂] was confirmed by single-crystal X-ray diffraction. The geometry of the Cu(I) complexes was optimized through DFT calculations, and the nature of the Cu···O interaction was investigated through AIM analysis. The three Cu(I) complexes were characterized by intense absorption under 400 nm and, after being excited with blue irradiation, [Cu(BSeD)(PPh₃)₂(ClO₄)] and [Cu₂(μ₂-BSeD)(PPh₃)₄(ClO₄)₂] exhibited weak red emissions centered at 700 nm. The lifetimes comprised between 121 and 159 μs support the involvement of triplet excited states in the emission process. The photoluminescent properties of [Cu(BSeD)(PPh₃)₂(ClO₄)] were supported by TDDFT computations, and the emission was predicted at 710 nm and ascribed to a metal-to-ligand charge transfer (³MLCT) process, in agreement with the experimental data. Full article

The homoleptic cationic complex formed by reacting suitable manganese(II) salts with 2,2′-bipyridine-1,1′-dioxide (bipyO₂) has been subjected to several studies in the past because of its peculiar absorption and electrochemical features. Here, the first single-crystal X-ray structure determination of a [Mn(bipyO₂)₃]²⁺ salt is reported, where the charge of the cation is balanced by perchlorate anions. The hydrated salt [Mn(bipyO₂)₃](ClO₄)₂ crystallizes in the monoclinic system (P2₁/n space group) and the asymmetric unit contains three cationic complexes and six perchlorate anions. The environment of the manganese(II) ions is best described as octahedral, with scarce variations among the three cations in the asymmetric unit. The bipyO₂ ligands exhibit κ² coordination mode, forming seven-membered metallacycles. The X-ray outcomes have been used as the starting point for DFT and TDDFT calculations, aimed to elucidate the charge transfer origin of the noticeable absorption in the visible range. The MLCT nature is confirmed by the hole and electron distributions associated with the spin-allowed transitions. DFT calculations on the related manganese(III) complex indicate that the geometry of [Mn(bipyO₂)₃]²⁺ changes only slightly upon oxidation, in agreement with the reversible electrochemical behaviour experimentally observed. Full article

Cells and extracts derived from adipose tissue are gaining increasing attention not only in plastic surgery and for aesthetic purposes but also in regenerative medicine. The ability of hyaluronan (HA) to support human adipose stromal cell (hASC) viability and differentiation has been investigated. However, the compatibility of adipose tissue with HA-based formulation in terms of biophysical and rheological properties has not been fully addressed, although it is a key feature for tissue integration and in vivo performance. In this study, the biophysical and biochemical properties of highly concentrated (45 mg/mL) high/low-molecular-weight HA hybrid cooperative complex were assessed with a further focus on the potential application in adipose tissue augmentation/regeneration. Specifically, HA hybrid complex rheological behavior was observed in combination with different adipose tissue ratios, and hyaluronidase-catalyzed degradation was compared to that of a high-molecular-weight HA (HHA). Moreover, the HA hybrid complex’s ability to induce in vitro hASCs differentiation towards adipose phenotype was evaluated in comparison to HHA, performing Oil Red O staining and analyzing gene/protein expression of PPAR-γ, adiponectin, and leptin. Both treatments supported hASCs differentiation, with the HA hybrid complex showing better results. These outcomes may open new frontiers in regenerative medicine, supporting the injection of highly concentrated hybrid formulations in fat compartments, eventually enhancing residing staminal cell differentiation and improving cell/growth factor persistence towards tissue regeneration districts. Full article

The tetrafluoroborate salt of the cationic Cu(I) complex [Cu(CHpz₃)(PPh₃)]⁺, where CHpz₃ is the tridentate N-donor ligand tris(pyrazol-1-yl)methane and PPh₃ is triphenylphosphine, was synthesized through a displacement reaction on the acetonitrile complex [Cu(NCCH₃)₄][BF₄]. The compound crystallizes in the monoclinic P2₁/c space group. The single-crystal X-ray diffraction revealed that the copper(I) centre is tetracoordinated, with a disposition of the donor atoms surrounding the metal centre quite far from the ideal tetrahedral geometry, as confirmed by continuous shape measures and by the τ₄ parameter. The intermolecular interactions at the solid state were investigated through the Hirshfeld surface analysis, which highlighted the presence of several non-classical hydrogen bonds involving the tetrafluoroborate anion. The electronic structure of the crystal was modelled using plane-wave DFT methods. The computed band gap is around 2.8 eV and separates a metal-centred valence band from a ligand-centred conduction band. NMR spectroscopy indicated the fluxional behaviour of the complex in CDCl₃ solution. The geometry of the compound in the presence of chloroform as implicit solvent was simulated by means of DFT calculations, together with possible mechanisms related to the fluxionality. The reversible dissociation of one of the pyrazole rings from the Cu(I) coordination sphere resulted in an accessible process. Full article

The two enantiomers of chiral phosphonate 4-phenyldinaphtho[2,1-d:1′,2′-f][1,3,2]dioxaphosphepine 4-oxide, O=PPh(BINOL), were synthesized from the proper 1,1′-bi-2-naphtol (BINOL) enantiomer and characterized. The structure of the (S)-enantiomer was elucidated by means of single-crystal X-ray diffraction. The reaction with anhydrous ZnBr₂ afforded complexes having the general formula [ZnBr₂{O=PPh(BINOL)}₂] that showed intense fluorescence centered in the near-UV region rationalized on the basis of TD-DFT calculations. The corresponding Mn(II) complexes with the general formula [MnX₂{O=PPh(BINOL)}₂] (X = Cl, Br) exhibited dual emission upon excitation with UV light, with the relative intensity of the bands dependent upon the choice of the halide. The highest energy transition is comparable with that of the Zn(II) complex, while the lowest energy emission falls in the red region of the spectrum and is characterized by lifetimes in the hundreds of microseconds range. Although the emission at lower energy can also be achieved by direct excitation of the metal center, the luminescence decay curves suggest that the band in the red range is possibly derived from BINOL-centered excited states populated by intersystem crossing. Full article

Nitric oxide (NO) is produced within the airways and released with exhalation. Nasal NO (nNO) can be measured in a non-invasive way, with different devices and techniques according to the age and cooperation of the patients. Here, we conducted a narrative review of the literature to examine the relationship between nNO and some respiratory diseases with a particular focus on primary ciliary dyskinesia (PCD). A total of 115 papers were assessed, and 50 were eventually included in the review. nNO in PCD is low (below 77 nL/min), and its measurement has a clear diagnostic value when evaluated in a clinically suggestive phenotype. Many studies have evaluated the role of NO as a molecular mediator as well as the association between nNO values and genotype or ciliary function. As far as other respiratory diseases are concerned, nNO is low in chronic rhinosinusitis and cystic fibrosis, while increased values have been found in allergic rhinitis. Nonetheless, the role in the diagnosis and prognosis of these conditions has not been fully clarified. Full article

Lung cancer frequently affects patients with Chronic Obstructive Pulmonary Disease (COPD). Cigarette smoke (CS) fosters cancer progression by increasing oxidative stress and by modulating epithelial-mesenchymal transition (EMT) processes in cancer cells. Formoterol (FO), a long-acting β2-agonist widely used for the treatment of COPD, exerts antioxidant activities. This study explored in a lung adenocarcinoma cell line (A549) whether FO counteracted the effects of cigarette smoke extract (CSE) relative to oxidative stress, inflammation, EMT processes, and cell migration and proliferation. A549 was stimulated with CSE and FO, ROS were evaluated by flow-cytometry and by nanostructured electrochemical sensor, EMT markers were evaluated by flow-cytometry and Real-Time PCR, IL-8 was evaluated by ELISA, cell migration was assessed by scratch and phalloidin test, and cell proliferation was assessed by clonogenic assay. CSE significantly increased the production of ROS, IL-8 release, cell migration and proliferation, and SNAIL1 expression but significantly decreased E-cadherin expression. FO reverted all these phenomena in CSE-stimulated A549 cells. The present study provides intriguing evidence that FO may exert anti-cancer effects by reverting oxidative stress, inflammation, and EMT markers induced by CS. These findings must be validated in future clinical studies to support FO as a valuable add-on treatment for lung cancer management. Full article

Backgrounds: Liver surgery has developed progressively during the last 10 years, especially in minimally invasive approaches. Robotic surgery seemed to overcome laparoscopic limitations with 3D visualization, the increased degrees of freedom given with Endowrist instruments, tremor filtering, better dexterity, and improved ergonomics for the surgeon. Methods: This work was a retrospective analysis of our first 100 robotic hepatectomies from March 2020 to July 2022. Patient demographics characteristics and intra- and postoperative outcomes were analyzed. Results: A total of 59 males and 41 females, with a median age of 68 years, underwent a robotic liver resection. The indications for robotic liver resections were malignant lesions in 86% of patients. Anatomical resection (AR) was undertaken in 27% of cases and non-anatomical resection (NAR) in 63% of cases. None of the patients were converted to the ‘open’ approach. Postoperative complications were as follows: 1% of biliary leakage, 5% of ascites, 6% of pulmonary infections, and 3% of other sites’ infections. CONCLUSIONS Our results showed the satisfactory experience of a tertiary HPB center with its first 100 robotic liver resections. The opportunity to make the robotic approach routinary provided global growth of a surgical team, improving the quality of patient outcomes. Full article

Background: Asthma is the most common chronic condition in children. It is a complex non-communicable disease resulting from the interaction of genetic and environmental factors and characterized by heterogeneous underlying molecular mechanisms. Metabolomics, as with the other omic sciences, thanks to the joint use of high-throughput technologies and sophisticated multivariate statistical methods, provides an unbiased approach to study the biochemical–metabolic processes underlying asthma. The aim of this narrative review is the analysis of the metabolomic studies in pediatric asthma published in the past 10 years, focusing on the prediction of asthma development, endotype characterization and pharmaco-metabolomics. Methods: A total of 43 relevant published studies were identified searching the MEDLINE/Pubmed database, using the following terms: “asthma” AND “metabolomics”. The following filters were applied: language (English), age of study subjects (0–18 years), and publication date (last 10 years). Results and Conclusions: Several studies were identified within the three areas of interest described in the aim, and some of them likely have the potential to influence our clinical approach in the future. Nonetheless, further studies are needed to validate the findings and to assess the role of the proposed biomarkers as possible diagnostic or prognostic tools to be used in clinical practice. Full article