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Fortunato L, Rushton L. Stomach cancer and occupational exposure to asbestos: a meta-analysis of occupational cohort studies. Br J Cancer 2015; 112:1805-15. [PMID: 25928706 PMCID: PMC4647249 DOI: 10.1038/bjc.2014.599] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Revised: 10/16/2014] [Accepted: 10/27/2014] [Indexed: 11/18/2022] Open
Abstract
Background: A recent Monographs Working Group of the International Agency for Research on Cancer concluded that there is limited evidence for a causal association between exposure to asbestos and stomach cancer. Methods: We performed a meta-analysis to quantitatively evaluate this association. Random effects models were used to summarise the relative risks across studies. Sources of heterogeneity were explored through subgroup analyses and meta-regression. Results: We identified 40 mortality cohort studies from 37 separate papers, and cancer incidence data were extracted for 15 separate cohorts from 14 papers. The overall meta-SMR for stomach cancer for total cohort was 1.15 (95% confidence interval 1.03–1.27), with heterogeneous results across studies. Statistically significant excesses were observed in North America and Australia but not in Europe, and for generic asbestos workers and insulators. Meta-SMRs were larger for cohorts reporting a SMR for lung cancer above 2 and cohort sizes below 1000. Conclusions: Our results support the conclusion by IARC that exposure to asbestos is associated with a moderate increased risk of stomach cancer.
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Figliuzzi MM, Giudice A, Cristofaro MG, Pacifico D, Biamonte P, Fortunato L. Postextractive implants in aesthetic areas: evaluation of perimplant bone remodeling over time. ANNALI DI STOMATOLOGIA 2015; 6:29-34. [PMID: 26161250 PMCID: PMC4475908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
AIM The aim of this research was to assess peri-implant bone remodeling of post-extractive implants over 2 years. MATERIAL AND METHODS 30 patients meeting pre-established inclusion criteria were enrolled for the study. One implant for each patient was inserted in the post-extraction sockets according to a defined surgical protocol (atramautic extraction, curettage of extraction socket, implant insertion, grafting with collagenated cortico-cancellous porcine bone, and a trimmed collagen membrane to completely cover the socket, suture). A temporary adhesive bridge, with an adequate profile, was bonded to the adjacent teeth. X-ray evaluation with a standardized stent was carried out at different times. Measurements were obtained from the implant edge to the bone peak. The values obtained at time 0 and at 2 years were compared by t-student test. RESULT Our results showed that after one year 73% of patient had 0 mm of bone reabsorption, 20% of patient had 0 mm ≤ x ≤ 0.5mm, 7% of patient had 0.5 mm ≤ x ≤ 2 mm of bone reabsorption. After two years 62% of patient had 0 mm of bone reabsorption, 24% had 0 mm ≤ x ≤ 0.5mm, 14% had 0.5 mm ≤ x ≤ 2 mm. CONCLUSIONS The results showed no significant differences in bone reabsorption in most patients over 2 years.
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Crispino A, Figliuzzi MM, Iovane C, Del Giudice T, Lomanno S, Pacifico D, Fortunato L, Del Giudice R. Effectiveness of a diode laser in addition to non-surgical periodontal therapy: study of intervention. ANNALI DI STOMATOLOGIA 2015; 6:15-20. [PMID: 26161248 PMCID: PMC4475909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND Chronic periodontitis affects 47% of adult population over the age of 30. The first phase of periodontal treatment is always represented by scaling and root planning (SRP), that is a causal, non-surgical therapy that recognizes as primary aims the control of bacterial infection and the reduction of periodontal plaque-associated inflammation. Yet, another innovative causal therapy is represented by the irradiation of periodontal pockets with laser. AIM To evaluate the effect of a 940-nm diode laser as an adjunct to SRP in patients affected by periodontitis. MATERIALS AND METHODS Sixty-eight adult patients with moderate-to-severe periodontitis were sequentially enrolled and undergone to periodontal examination (V1) in order to detect gingival index (GI), plaque index (PI) and probing depth (PD). The patients were randomly divided into two groups: the first (n=34) received SRP treatment alone, the control group (n=34) received SRP and 940-nm diode laser therapy. RESULTS Data were analyzed by Student's t-test, with two tails; for all clinical parameters, both groups reported statistically significant differences compared to basal values (p<0.0001). Both procedures were effective in improving GI, PI and PD, but the use of diode laser was associated with more evident results. CONCLUSIONS Considered the better clinical outcomes, diode laser can be routinely associated with SRP in the treatment of periodontal pockets of patients with moderate-to-severe periodontitis.
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Carallo C, Irace C, Tripolino C, De Franceschi MS, Procopio A, Crispino A, Fortunato L, Gnasso A. Time course analysis of brachial artery flow mediated dilatation in subjects with gingival inflammation. INT ANGIOL 2014; 33:565-572. [PMID: 24927022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
AIM Several investigations report an inverse association between periodontal disease and endothelial function measured by brachial artery Flow-Mediated-Dilatation (FMD) technique. These studies examined endothelial function by using the traditional approach to FMD calculation, that is from diameters assessed at 60 seconds after deflation. Nevertheless, possible relationship between gingival inflammation and endothelial dysfunction observed over this temporal threshold remains still unexplored. The purpose of our study was to explore the relationship between gingival inflammation and endothelial function, by considering the time course of brachial FMD. METHODS Forty-six free-living white subjects, participating in a cardiovascular disease prevention campaign, were enrolled. FMD was measured at 60s and at 2 and 3 min after forearm ischemia. Maximal FMD was calculated (Peak FMD), for each patient. Gingival Index (GI) was evaluated as measure of gingival inflammation. RESULTS In univariate analyses, GI was associated with both FMD at 60 sec (r=-0.30, P=0.038) and Peak FMD (r=-0.41, P=0.004). In multiple regression analyses including GI, age, gender, and known risk factors for atherosclerosis, only GI and age were independently and inversely associated with Peak FMD and FMD at 60 s, but this association was stronger with Peak FMD. Moreover, when we divided subjects on the basis of GI value, patients with GI > 1 presented lower Peak FMD and higher prevalence of absent FMD. CONCLUSION The present study extends previous observations about the negative effects of periodontal disease on endothelial function, highlighting the importance of the evaluation of time course of vascular reactivity.
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de Paula U, D’Angelillo R, Caccavari A, Antonaci A, Barbara R, Cavaliere F, Costarelli L, La Pinta M, Loreti A, Mauri M, Santini E, Scavina P, Fortunato L. Full Local Control With Accelerated Partial Breast Irradiation (APBI) by Tomotherapy After Breast-Conservative Surgery for Patients Suitable, or Not, According to ASTRO-2009 Consensus Statement: Interim Report After 2 Years Follow-Up. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Figliuzzi MM, De Fazio R, Tiano R, De Franceschi S, Pacifico D, Mangano F, Fortunato L. Histological evaluation of a biomimetic material in bone regeneration after one year from graft. ANNALI DI STOMATOLOGIA 2014; 5:103-107. [PMID: 25506415 PMCID: PMC4252859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
AIM The use of substitute materials is one of the solutions used in periodontology for the reconstruction of intrabony defects. Advances in scientific research gave rise to a new generation of biomaterials of synthetic origin stoichiometrically unstable and therefore really absorbable. Our research is directed precisely towards a biomaterial synthesis, Engipore® (Finceramica, Faenza, Italy) which is a bone substitute of the latest hydroxyapatite-based generation, that possesses chemical and morphological properties similar to those of natural bone in the treatment of infrabony periodontal defects. Aim of this study was to evaluate the efficacy of Engipore® in the treatment of intrabony periodontal defects. METHODS The study was conducted on 100 parodontopatics patients, which had gingival pockets of at least infrabonies 8/10 mm. The histological evaluation was performed with samples after one year from the graft. RESULTS The histological samples collected after one year showed an abundant new bone formation, with mature lamellar bone tissue surrounding the residual particles of Engipore® that appear completely osteointegrated. The surrounding connective tissue shows no signs of inflammation. CONCLUSIONS The results obtained in our research demonstrated that, after a proper selection of patients and lesions, and applying an adequate surgical technique, this type of biomaterial in the treatment of periodontal defects acts in an optimal manner as a filler inducing the formation of new bone as evidenced by histological examinations.
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Crispino A, Iovane C, Lidonnici L, Fortunato L. Immediately loaded post-extraction implant. Case report and literature review. Ann Ital Chir 2014; 85:365-371. [PMID: 25263504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Thanks to the recent scientific improvements, the insertion of immediately loaded post-extraction implants has become a routine, rather than elective, surgical treatment, which vaunts a success rate close to 100%. AIM The purpose of this study is to analyze the actual status regarding this field and to critically review the current available literature. MATERIAL OF STUDY A research was made in the Pubmed database, by using the keywords "immediate loading", "postextraction", "dental implant", for studies published in the last 10 years. Sixty articles were selected in this review in order to investigate and define indications and counter-indications, benefits and disadvantages, pre-surgical evaluation and surgical technique, influential factors and available technologies for planning of this treatment. RESULTS The dental implants into fresh extraction sockets and their immediate loading is associated with a high success and survival rate, comparable with those obtained in case of conventional delayed loading. Many studies show the practicability and expectation of this procedure. DISCUSSION The immediate loading of dental implants reduces the risk for osteo fibro integration by inducing a more dense perimplant bone apposition. Factors that influence the success of this treatment are: patient selection, bone quality and density, micro- and macrostructure of the implant, surgical technique, control of occlusal forces, prosthesis guidelines and the achievement of primary stability. CONCLUSIONS It may be concluded that this surgical protocol, if well-managed, guarantees the desired implant-prosthetic outcome, shows a high aesthetic result and reduces treatment time, by ensuring the comfort and by making the patient satisfied.
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Nobile CGA, Fortunato L, Bianco A, Pileggi C, Pavia M. Pattern and severity of early childhood caries in Southern Italy: a preschool-based cross-sectional study. BMC Public Health 2014; 14:206. [PMID: 24571668 PMCID: PMC3941481 DOI: 10.1186/1471-2458-14-206] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Accepted: 02/19/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This survey was intended to investigate prevalence and severity of early childhood caries (ECC) in a sample of children in Southern Italy and to identify factors that may be related to this condition. METHODS The study was designed as a cross-sectional survey. The study population (children aged 36-71 months) attending thirteen kindergartens was randomly selected through a two-stage cluster sampling procedure. Parents/guardians of all eligible children were invited to participate filling out a structured self-administered questionnaire, and after having returned the informed consent form an oral examination of the child was performed at school. The questionnaire included information on: socio-demographics about parents/guardians and child, pregnancy and newborn characteristics, oral hygiene habits of child, eating habits particularly on consumption of sweets, access to dental services, and infant feeding practices. The WHO caries diagnostic criteria for deciduous decayed, missing and filled teeth (dmft) and surfaces (dmfs) were used to record ECC and severe-ECC (S-ECC). Univariate and multiple logistic regression analyses were conducted to evaluate statistical associations of social demographics, infant feeding practices, oral hygiene habits, and access to dental services to ECC, S-ECC, dmft and dmfs. RESULTS 515 children participated in the study. 19% had experienced ECC, and 2.7% severe-ECC (S-ECC), with a mean dmft and dmfs scores of 0.51 and 0.99, respectively. Mean dmft was 2.68 in ECC subjects, and 6.86 in S-ECC subjects. Statistical analysis showed that prevalence of ECC significantly increased with age (OR = 1.95; 95% CI = 1.3-2.91) and duration of breastfeeding (OR = 1.26; 95% CI = 1.01-1.57), whereas it was significantly lower in children of more educated mothers (OR = 0.64; 95% CI = 0.42-0.96), and higher in those who had been visited by a dentist in the previous year (OR = 3.29; 95% CI = 1.72-6.33). CONCLUSIONS Results of our study demonstrate that even in Western countries ECC and S-ECC represent a significant burden in preschool children, particularly in those disadvantaged, and that most of the known modifiable associated factors regarding feeding practices and oral hygiene are still very spread in the population.
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Böyükata M, Alonso CE, Arias JM, Fortunato L, Vitturi A. Quantum shape phase transitions from spherical to deformed for Bose-Fermi systems: the effect of the odd particle around the critical point. EPJ WEB OF CONFERENCES 2014. [DOI: 10.1051/epjconf/20146602014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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De Paula U, Muni R, Renato A, Adriana A, Barbara R, Caccavari A, Costarelli L, Di Palma A, Loreti A, Mauri M, Petrocchi A, Santini E, Scavina P, Fortunato L. Accelerated partial breast irradiation (APBI) with tomotherapy HI-ART on 85 patients treated at San Giovanni-Addolorata Hospital Rome: Preliminary report. Eur J Surg Oncol 2013. [DOI: 10.1016/j.ejso.2013.07.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Piccaluga E, Andreassi MG, Chiesa MR, Fortunato L, Trivellini G, Molinaro S, Cremonesi G, Guagliumi G, Picano E. Occupational risks in cardiac catheterization laboratory workers. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.p5478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Carallo C, De Franceschi MS, Tripolino C, Figliuzzi M, Irace C, Fortunato L, Gnasso A. Common carotid and brachial artery hemodynamic alterations in periodontal disease. J Clin Periodontol 2013; 40:431-6. [PMID: 23517219 DOI: 10.1111/jcpe.12099] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2013] [Indexed: 11/28/2022]
Abstract
AIM In patients affected by periodontal disease, hypertension and systemic inflammation might cause an arterial hemodynamic derangement; this, in turn, can act as a mediator of the atherogenic process often seen in these patients. This study aimed at a comprehensive hemodynamic evaluation in periodontal patients. METHODS Fourty-eight subjects participating to a cardiovascular prevention programme were enrolled. Periodontitis, classical risk factors for atherosclerosis, and shear and tensile forces in both carotid and brachial arteries were evaluated. Calculated periodontal indexes were plaque, gingival and pocket deep (PD) indexes. Simple and multiple regression analyses were performed. Afterwards, 30 of them with normal PD index were compared with 30 carefully - matched patients with periodontitis. RESULTS Brachial and carotid parietal tension were significantly associated with periodontal indexes, especially PD-Sum, in both simple (r = 0.42, p < 0.001 for carotid artery and r = 0.36, p < 0.02 for brachial artery) and multiple regression analyses. Shear stress gave similar results. In case-control analysis, shear stress was lower by 15% and 30%, respectively, in carotid and brachial artery in patients with high PD; common carotid parietal tension was higher. Arterial stiffness resulted not associated with periodontitis. CONCLUSIONS Periodontal disease is associated to a complex atherosclerotic prone hemodynamic derangement, particularly in large elastic arteries.
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Fortunato L, Loreti A, Andrich R, Costarelli L, Amini M, Farina M, Vitelli C. 530 When Mastectomy is Needed – is the Nipple Sparing Procedure a New Standard with Very Few Contraindications? Eur J Cancer 2012. [DOI: 10.1016/s0959-8049(12)70595-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Mazzocco M, Signorini C, Pierroutsakou D, Glodariu T, Boiano A, Boiano C, Castellani L, Corti D, De Rosa A, Di Meo P, Farinon F, Figuera P, Filipescu D, Fortunato L, Galet G, Grebosz J, Guglielmetti A, Inglima G, La Commara M, Lattuada M, Lotti P, Manea C, Mazzocchi C, Molini P, Musumarra A, Nicoletto M, Pakou A, Parascandolo C, Patronis N, Romoli M, Sandoli M, Scuderi V, Silvestri R, Soramel F, Stroe L, Toniolo N, Torresi D, Vardaci E, Vitturi A. Does the breakup process affect the reaction dynamics for the systems17O,17F +58Ni at Coulomb barrier energies? EPJ WEB OF CONFERENCES 2011. [DOI: 10.1051/epjconf/20111713005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Rushton L, Hutchins S, Bagga S, Bevan R, Brown T, Cherrie J, Holmes P, Fortunato L, Slack R, Van Tongeren M, Young C. O2-5.5 Estimation of the burden of occupational cancer in Great Britain. J Epidemiol Community Health 2011. [DOI: 10.1136/jech.2011.142976a.74] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Carallo C, Fortunato L, de Franceschi MS, Irace C, Tripolino C, Cristofaro MG, Giudice M, Gnasso A. Periodontal disease and carotid atherosclerosis: are hemodynamic forces a link? Atherosclerosis 2010; 213:263-7. [PMID: 20732683 DOI: 10.1016/j.atherosclerosis.2010.07.025] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2010] [Revised: 07/09/2010] [Accepted: 07/19/2010] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The link between periodontal disease and atherosclerosis has not yet been clarified, though systemic inflammation seems to be the common soil for both conditions. Inflammation influences also hemodynamic forces, that act as local risk factors for carotid plaques. It is not known if the link between periodontitis and carotid atherosclerosis is mediated, at least in part, by physical forces. Therefore, aim of the present study was to evaluate the association between carotid shear stress force and periodontal disease. METHODS Thirty-three subjects underwent complete cardiovascular screening, carotid hemodynamic evaluation and dental inspection. Presence of classical risk factors for atherosclerosis, common carotid peak and mean wall shear stress values and periodontal indices of disease (plaque index, gingival index and pocket deep) have been evaluated. RESULTS Worse periodontal health was associated to the presence of carotid atherosclerosis. Patients with carotid plaques (n=19) had higher periodontal indices compared with subjects without plaques (n=14) (gingival index: 1.40 ± 0.71 vs. 0.69 ± 0.64, p=0.006). These relations were independent of the presence of cardiovascular risk factors in multiple logistic regression analysis. In the 66 examined common carotids, wall shear stress was inversely related to all periodontal indices (r=0.54, p<0.00001 for peak wall shear stress and gingival index). These relations remained significant also in multiple regression analysis, after correction for cardiovascular risk factors, gender and age. CONCLUSIONS The present study identifies for the first time a link between periodontal indices and wall shear stress, suggesting that an alteration of hemodynamic profile might contribute to atherosclerosis in subjects with periodontal disease.
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Abstract
The majority of human societies allow polygynous marriage, and the prevalence of this practice is readily understood in evolutionary terms. Why some societies prescribe monogamous marriage is however not clear: current evolutionary explanations--that social monogamy increases within-group co-operation, giving societies an advantage in competition with other groups--conflict with the historical and ethnographic evidence. We show that, within the framework of inclusive fitness theory, monogamous marriage can be viewed as the outcome of the strategic behaviour of males and females in the allocation of resources to the next generation. Where resources are transferred across generations, social monogamy can be advantageous if partitioning of resources among the offspring of multiple wives causes a depletion of their fitness value, and/or if females grant husbands higher fidelity in exchange for exclusive investment of resources in their offspring. This may explain why monogamous marriage prevailed among the historical societies of Eurasia: here, intensive agriculture led to scarcity of land, with depletion in the value of estates through partitioning among multiple heirs. Norms promoting high paternity were common among ancient societies in the region, and may have further facilitated the establishment of social monogamy. In line with the historical and ethnographic evidence, this suggests that monogamous marriage emerged in Eurasia following the adoption of intensive agriculture, as ownership of land became critical to productive and reproductive success.
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Fortunato L, Mascaro A, Andrich R, Costarelli L, Farina M, Amini M, Vitelli C. 219 Lobular cancer is different, but its surgical management is changing over time: analysis of an institutional database over a 10-year period. EJC Suppl 2010. [DOI: 10.1016/s1359-6349(10)70247-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Rushton L, Brown TP, Cherrie J, Fortunato L, Van Tongeren M, Hutchings SJ. How much does benzene contribute to the overall burden of cancer due to occupation? Chem Biol Interact 2009; 184:290-2. [PMID: 19914225 DOI: 10.1016/j.cbi.2009.11.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Bianco A, Fortunato L, Nobile CGA, Pavia M. Prevalence and determinants of oral impacts on daily performance: results from a survey among school children in Italy. Eur J Public Health 2009; 20:595-600. [PMID: 19892850 DOI: 10.1093/eurpub/ckp179] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The use of health status measures to assess health-related quality of life is not widespread. The objectives of this study were to assess the prevalence, characteristics and severity of oral impacts on health using the Child-Oral Impact on Daily Performance (Child-OIDP). METHODS The survey was conducted on 11-16 years old randomly selected students in Catanzaro. Data were collected through a self-administered questionnaire, an interview for the calculation of Child-OIDP and the Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN) and an oral examination. RESULTS Only 5.5% out of 530 children did not report any dental problem in the previous 3 months and 66.8% had experienced dental impacts according to the Child-OIDP. Sex, fruit intake frequency, mouthwash habits and IOTN AC score assessed by dentist were significant risk factors for dental impacts. CONCLUSION Our findings suggest that the measurement of Oral Health-Related Quality of Life (OHRQoL) should be an essential component of oral health surveys.
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Salhi A, Rainò G, Fortunato L, Tasco V, Martiradonna L, Todaro MT, De Giorgi M, Cingolani R, Passaseo A, Luna E, Trampert A, De Vittorio M. Linear increase of the modal gain in 1.3 µm InAs/GaAs quantum dot lasers containing up to seven-stacked QD layers. NANOTECHNOLOGY 2008; 19:275401. [PMID: 21828705 DOI: 10.1088/0957-4484/19/27/275401] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The authors have recently demonstrated the enhancement of the quantum dot laser modal gain, linearly scaling with the number of stacked QD layers. These results allowed the achievement of multi-quantum dot (MQD) lasers, the zero-dimensional counterpart of MQW lasers, with a modal gain as high as 42 cm(-1), in a seven-layer structure. A detailed investigation of the structural and optical properties was performed on laser structures with three, five and seven QD layers. Such an investigation clearly shows that the high uniformity of QD layer features is responsible for the linear increase of the modal gain and its high value.
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Mascaro A, Vitelli C, Baldi A, Farina M, Amini M, Piro F, Fortunato L. Positive bone marrow biopsy is associated with a decreased event-free survival in patients with breast cancer. EJC Suppl 2008. [DOI: 10.1016/s1359-6349(08)70382-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Fortunato L, Amini M, Piro F, Costarelli L, Farina M, Mascaro A, Vitelli C. Serial sections of sentinel lymph nodes in breast cancer: How much do you need to cut? EJC Suppl 2008. [DOI: 10.1016/s1359-6349(08)70659-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Fortunato L, Penteriani R, Farina M, Vitelli CE, Piro FR. Intraoperative ultrasound is an effective and preferable technique to localize non-palpable breast tumors. Eur J Surg Oncol 2008; 34:1289-92. [PMID: 18248946 DOI: 10.1016/j.ejso.2007.11.011] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2007] [Accepted: 11/27/2007] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION Non-palpable breast tumors represent an increasing management problem in modern Breast Units. Therefore, a simple and accurate procedure to localize these lesions is needed. To date, the most commonly used technique is wire localization, but there are some disadvantages. METHODS We conducted a prospective study on patients with malignant or benign non-palpable breast tumors who were surgically treated and underwent intraoperative ultrasound (IOUS) from May 2006 to June 2007. Margins of excision were inked and specifically assessed by the pathologist, and were considered positive if <or=1 mm. RESULTS There were 77 patients (60 malignant and 17 benign lesions), with a median age of 54 years (36-87), and a median diameter of 9mm (4-17). All lesions were correctly identified and localized by IOUS, and free margins of excision were obtained in 75/77 cases (97%). Only two patients required a re-excision, one for multifocal disease and one for margins of excision of 1mm. In the remaining cases, the median distance from the tumor to the closest margins of excision, with exclusion of the posterior (fascial) and anterior (skin) margins, was 1.3cm (0.3-3.2). CONCLUSIONS IOUS is a simple and accurate procedure that can be used to identify most non-palpable breast tumors, and has many advantages over the more commonly used wire-localization technique.
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Nobile CGA, Pavia M, Fortunato L, Angelillo IF. Prevalence and factors related to malocclusion and orthodontic treatment need in children and adolescents in Italy. Eur J Public Health 2007; 17:637-41. [PMID: 17400542 DOI: 10.1093/eurpub/ckm016] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The purpose of this study was to determine prevalence of malocclusions, normative and perceived orthodontic treatment need and related risk factors in schoolchildren in Italy. DESIGN A random sample of 1000 11-15 years old children was selected from randomly selected schools in Catanzaro (Italy). Parents completed a questionnaire on sociodemographic, orthodontic history and perception of their child orthodontic treatment need. Children were interviewed on utilization of dental services, perception of orthodontic treatment need and use of orthodontic devices. The Decayed, Missing, Filled Teeth (DMFT) index and the Dental Health Component (DHC) of the Index of Orthodontic Treatment Need (IOTN) were assessed. The Aesthetic Component (AC) of IOTN was assessed by parents, children and dentist. RESULTS A total of 546 children participated in the study. Three hundred and twenty-five subjects (59.5%) were assigned a 4 or 5 IOTN score, thus requiring orthodontic treatment. Definite treatment need (AC score 8-10) was reported for 8.6% of subjects by the orthodontist, 5.4% by parents and 3.2% by children. Higher DMFT significantly predicted orthodontic treatment need according to IOTN. Perceived orthodontic treatment need was significantly predicted by orthodontic treatment need for crowding/spacing and overjet. CONCLUSION A high proportion of children needs normative orthodontic treatment and perceptions of orthodontic treatment do not overlap with normative need.
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Abstract
OBJECTIVES To determine the prevalence of dental and root caries, periodontal conditions, and prosthetic status of prison inmates. DESIGN Cross-sectional survey. SETTING Penal institutions in the Calabria region (Italy). PARTICIPANTS A random sample of 544 prisoners. METHODS Participants underwent a structured interview by trained interviewers and a dental examination. RESULTS Only 2% had no history of caries. Mean DMFT and DMFS were 9.8 and 37.6 and missing teeth was the most prevalent component of the DMFT. Higher DMFT was found among older prisoners, having regular dental attendance, higher plaque index, and in those with a lower frequency of a tooth brushing habit. Conservative care and extractions were required by 61.9% and 33.3%. The mean plaque and gingival indices were 0.74 and 0.75; 10.5% had healthy periodontal tissues. The highest number of individuals was classified as having a CPI of 2, whereas 5% had at least one sextant with a CPI score of 4. Deep pockets were more likely in older subjects and in those with a lower frequency of a tooth brushing habit. A minimum of oral hygiene instruction was needed by 89.6%. Seven subjects were edentulous and 85.1% had a prosthetic treatment need. CONCLUSIONS This survey emphasises the need for programmes to improve the oral health of prisoners.
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Fortunato L, Amini M, Costarelli L, Piro F, Farina M, Vitelli C. A standardized sentinel lymph node enhanced pathology protocol (SEPP) in patients with breast cancer. J Surg Oncol 2007; 96:470-3. [DOI: 10.1002/jso.20767] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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79
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Fortunato L, Baldi A, Farina M, Campioni M, Amini M, Piro FR, Costarelli L, Pompili P, Vitelli CE. Bone marrow and sentinel lymph node biopsy in patients with breast cancer: from staging to ultrastaging? JOURNAL OF EXPERIMENTAL & CLINICAL CANCER RESEARCH : CR 2006; 25:487-93. [PMID: 17310838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Bone marrow (BM) biopsy has been suggested as an independent prognostic tool to improve staging in patients with breast cancer. Two hundred and ten consecutive patients operated for breast cancer from June 2000 to June 2005 who signed an informed consent were enrolled in this protocol. Patients underwent SLN biopsy, and lymph nodes were analysed with serial sections and stained with hematossilin-eosin and immunohistochemistry. At the end of the procedure a BM aspirate from the iliac crest was obtained and 5-10 cc of blood collected. A CEA specific nested reverse transcriptase (RT) polymerase chain reaction (PCR) assay was used to examine BM samples. Results were blinded to both patients and clinicians. The median age of the patients was 56 years (range 34-80), and the median tumor diameter 1,5 cm (range 0.2-4.5). BM aspirates were unsuccessful in ten patients, and RT-PCR was not technically feasible in seventeen women, leaving 183 patients available for analysis of results and follow up. SLN biopsy allowed diagnoses of occult metastases (micrometastases and isolated tumor cells) in 16% of patients (29/183). 25% of T1N0 patients (23/92), 35% of T2N0 patients (6/17), and 44% of N1-2 patients (32/72) were BM+ (p = 0.03). At a median follow up of 35 months 5/122 in the BM- group and 6/61 in the BM+ group have relapsed (p = 0.2), while 1/122 and 4/61 have died of disease (p = 0.04) In conclusion, ultrastaging of breast cancer patients may identify a substantial subgroup of patients N-/BM- who may not require adjuvant chemotherapy, as well as a subgroup N-/BM+ with a decreased survival who may need more aggressive therapies. Further follow-up is needed to confirm this hypothesis, and several studies are under way.
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80
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Drago S, Fortunato L, Gucciardo G, Cabassi A, Santoni M, Baldini D, Grillo R, Amini M, Vitelli C, Grassi G. 261 POSTER Sentinel node micrometastases - evidence from the Rome Breast Cancer Study Group. Eur J Surg Oncol 2006. [DOI: 10.1016/s0748-7983(06)70696-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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81
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La Torre M, Penteriani R, La Pinta M, Farina M, Vitelli C, Fortunato L. 279 POSTER Intraoperative ultrasound for nonpalpable breast lesions: a preliminary report. Eur J Surg Oncol 2006. [DOI: 10.1016/s0748-7983(06)70714-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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82
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Clark RM, Macchiavelli AO, Fortunato L, Krücken R. Critical-point description of the transition from vibrational to rotational regimes in the pairing phase. PHYSICAL REVIEW LETTERS 2006; 96:032501. [PMID: 16486691 DOI: 10.1103/physrevlett.96.032501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2005] [Indexed: 05/06/2023]
Abstract
An approximate solution at the critical point of the pairing transition from harmonic vibration to deformed rotation in gauge space is found by analytic solution of the collective pairing Hamiltonian. The eigenvalues are expressed in terms of the zeros of Bessel functions of integer order. The results are compared to the pairing bands based on the Pb isotopes.
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Heyde K, Fortunato L, Wood JL. Comment on "anomalously hindered E2 strength B(E2;2+1 --> 0+) in 16C". PHYSICAL REVIEW LETTERS 2005; 94:199201; author reply 199202. [PMID: 16090225 DOI: 10.1103/physrevlett.94.199201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2004] [Indexed: 05/03/2023]
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84
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Vitelli CE, Fortunato L, Crenca F, Di Nardo A, Zarrelli G, Farina M, Bianca S. [Locally advanced and recurrent pelvic colorectal carcinoma: results of aggressive surgical treatment]. I SUPPLEMENTI DI TUMORI : OFFICIAL JOURNAL OF SOCIETA ITALIANA DI CANCEROLOGIA ... [ET AL.] 2005; 4:S4. [PMID: 16437868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Pelvic exenteration has been described as a formidable procedure in cases of advanced or recurrent pelvic cancers for a variety of primary tumors, including colorectal, gynaecologic and urologic. We report our 14-year experience in a community hospital with 37 cases who underwent pelvic exenteration for recurrent (n = 15) or locally advanced (n = 22) colorectal cancers. At a median follow-up of 36 months, the median survival was 24 and 36 months, respectively, and the 5-year actuarial survival was 18% and 44%.
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85
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Fortunato L, Farina M, Amini M, Costarelli L, Piro FR, Dell'Osso A, Scattoni F, Pompili P, Rapacchietta S, Vitelli CE. [Does incidence of sentinel lymph node metastasis increase after diagnostic manipulation in women with breast cancer?]. I SUPPLEMENTI DI TUMORI : OFFICIAL JOURNAL OF SOCIETA ITALIANA DI CANCEROLOGIA ... [ET AL.] 2005; 4:S174-5. [PMID: 16437971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
503 patients were retrospectively evaluated to assess whether a previous needle or core biopsy, or surgical surgical excision of the primary tumor are associated with passive dislodgment of tumor cells in the sentinel lymph node, as reported in recent publications. We could not identify any increased incidence of sentinel lymph node micrometastases or isolated tumor cells after diagnostic manipulation of the primary tumor.
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86
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Fortunato L, Amini M, Costarelli L, Piro FR, Farina M, Dell'Osso A, Sbarbati S, Pompili P, Cortesi F, Vitelli CE. [Towards the standardization of sentinel lymph node analysis in women with breast cancer]. I SUPPLEMENTI DI TUMORI : OFFICIAL JOURNAL OF SOCIETA ITALIANA DI CANCEROLOGIA ... [ET AL.] 2005; 4:S173. [PMID: 16437970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Sentinel lymph node biopsy allows enhanced pathology through serial sections and immunohistochemical analysis of the retrieved node, with detection of micrometastases and isolated tumor cells not otherwise recognized. We present our experience with a simple, effective, pathology protocol requiring six couples of sections at three different sentinel lymph node levels. Additional micrometastases or ITC were diagnosed in 51/416 patients (14.6%).
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87
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Costarelli L, Piro FR, Fortunato L, Vitelli CE, Farina M, Taffuri M, Amini M, Nofroni I. [Predictive variables of lymphatic metastasis in breast carcinoma with a diameter below 2 cm]. I SUPPLEMENTI DI TUMORI : OFFICIAL JOURNAL OF SOCIETA ITALIANA DI CANCEROLOGIA ... [ET AL.] 2005; 4:S172. [PMID: 16437969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
The axillary lymph node status of patients with newly diagnosed breast cancer remains the most important prognostic information available at the moment. However, only a minority of patients presents with such node metastases at diagnoses. We reviewed our database and studied 500 consecutive patients with early breast cancer, and found that age inferior to 50 years, high grade, diameter superior to 1 cm, elevated Ki-67, and expression of oncogene p-53 are all factors associated with lymph node metastases.
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88
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Persichetti P, Cagli B, Tenna S, Fortunato L, Vitelli CE. [Role of cutaneous thoraco-abdominal flap in the surgical treatment of advanced stage breast tumors]. I SUPPLEMENTI DI TUMORI : OFFICIAL JOURNAL OF SOCIETA ITALIANA DI CANCEROLOGIA ... [ET AL.] 2005; 4:S177. [PMID: 16437973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Chest wall reconstruction following extensive resection due to advanced breast cancer or radionecrosis still represents a challenge for both oncologic and reconstructive surgeons. A multitude of techniques including pedicle muscle transposition, free muscle flaps and omental flaps have always been considered, despite the morbidity of donor site. The authors describe a new cutaneous thoraco-abdominal flap to cover full thickness defects up to 600 cm2. 16 patients underwent chest wall reconstruction with the aforementioned technique. No major complications occurred. This technique proved to be a very good options to cover large chest wall defects in patients with advanced or recurred breast cancer or radionecrosis.
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Persichetti P, Tenna S, Cagli B, Fortunato L, Vitelli CE. [Strategic approach to immediate breast reconstruction with submuscular-fascial tissue expanders]. I SUPPLEMENTI DI TUMORI : OFFICIAL JOURNAL OF SOCIETA ITALIANA DI CANCEROLOGIA ... [ET AL.] 2005; 4:S176. [PMID: 16437972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Breast reconstruction can be accomplished with implants, autologous tissue or both. Thanks to the widespread of microsurgical techniques autologous tissue reconstruction has become a frequent option in many departments although it is mostly considered a second choice. The aim of this study was to review our experience covering the past five years in immediate breast reconstruction with tissue expanders. From January 2000 to January 2005 279 patients underwent immediate breast reconstruction with submuscular tissue expanders. Tissue expander was chosen according to dimension, shape and volume of the healthy breast. Operating time, early and late complications, interference with neo-adjuvant therapies as well as timing and surgical techniques of second-step reconstruction were also considered. No major complications occurred. Tissue expander, beyond proving itself a valid and safe option in immediate breast reconstruction, also decreased the psychological distress following a mastectomy.
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90
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Costarelli L, Piro FR, Fortunato L, Vitelli CE, Farina M, Taffuri M, Amini M. [Hormone-dependence and C-ERBB2: relationship between estrogen receptor expression, estrogen-regulated proteins, and C-ERBB2 in breast carcinoma]. I SUPPLEMENTI DI TUMORI : OFFICIAL JOURNAL OF SOCIETA ITALIANA DI CANCEROLOGIA ... [ET AL.] 2005; 4:S171. [PMID: 16437968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
We reviewed 1491 consecutive cases of operated breast cancer between 1999-2004, and found that hormone-dependence, particularly if evaluated with functional markers of the estrogen receptor (estrogen regulated proteins, ERP), is inversely proportional to antigen neu expression. Our data confirms that ERP can give additional information on the probability of response to hormonal therapy.
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91
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Vitelli CE, Crenca F, Fortunato L, Di Nardo A, Farina M, Mustacciuoli G. Pelvic exenterative procedures for locally advanced or recurrent colorectal carcinoma in a community hospital. Tech Coloproctol 2004; 7:159-63. [PMID: 14628159 DOI: 10.1007/s10151-003-0028-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2003] [Accepted: 07/16/2003] [Indexed: 10/26/2022]
Abstract
BACKGROUND We describe our experience with exenterative pelvic surgery for colorectal cancer in a small community hospital. METHODS We retrospectively evaluated 26 consecutive patients (14 women) with locally advanced (n=16) or recurrent (n=10) colorectal adenocarcinomas who underwent pelvic exenterations between August 1990 and December 2001 in our service. RESULTS Seventeen patients had posterior pelvic exenteration (PPE), eight had total pelvic exenteration (TPE) and one had TPE with internal hemipelvectomy. Major morbidity occurred in 12 patients (46%), causing 3 deaths (11%) in the immediate postoperative period. Fourteen of 23 patients who survived the immediate postoperative period have relapsed (61%). At a median follow-up of 42 months, the 5-year survival is 38%. CONCLUSION Pelvic exenterative procedures can be offered to patients with bulky or recurrent colorectal carcinomas with adequate results and satisfactory palliation, even in a community setting.
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Fortunato L, Amini M, Farina M, Rapacchietta S, Costarelli L, Piro F, Alessi G, Pompili P, Bianca S, Vitelli CE. [Extemporaneous examination of the sentinel lymph node in breast cancer: is the glass half full or half empty?]. TUMORI JOURNAL 2003; 89:192-3. [PMID: 12903590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
Intra-operative examination of sentinel LN is controversial. Concordance with definitive exam of SLN in this series was 81%, though only 54% of positive cases were diagnosed. Micrometastases and ITC were usually lost intraoperatively, accounting for 14% of cases. Frozen section and touch prep of the SLN were approximately equivalent. The latter has the advantage of preserving tissue for step-analysis of SLN. The ultimate method of intraoperative analysis of SLN which can combine cost-effectiveness and accuracy needs to be determined.
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93
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Calza L, Manfredi R, Marinacci G, Tadolini M, Fortunato L, Chiodo F. Efficacy of penicillin G benzathine as antimicrobial treatment of cutaneous secondary syphilis in patients with HIV infection. J Chemother 2002; 14:533-4. [PMID: 12462435 DOI: 10.1179/joc.2002.14.5.533] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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94
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Calza L, Manfredi R, Marinacci G, Fortunato L, Chiodo F. Community-acquired Pseudomonas aeruginosa sacro-iliitis in a previously healthy patient. J Med Microbiol 2002; 51:620-709. [PMID: 12132782 DOI: 10.1099/0022-1317-51-7-620] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Pyogenic sacro-iliitis is an uncommon osteo-articular infection that occurs usually in immunocompromised patients and is associated with gram-positive cocci. It is very rarely linked with a gram-negative aetiology. The first case of Pseudomonas aeruginosa sacro-iliitis is described, which occurred in a previously healthy young man, without history of prior traumatic events, hospitalisation or chronic underlying disease.
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95
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Splendiani G, Parolini C, Fortunato L, Sturniolo A, Costanzi S. Resistive index in chronic nephropathies: predictive value of renal outcome. Clin Nephrol 2002; 57:45-50. [PMID: 11837800 DOI: 10.5414/cnp57045] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
UNLABELLED The study of renovascular resistances by color Doppler ultrasound has become a useful diagnostic resource for nephrologists. In recent nephrological literature, many papers deal with the correlations between resistive index, anatomo-pathological patterns and renal function. AIMS In our study, we have tried to discover if resistive index represents a prognostic index of progressive renal failure. MATERIAL AND METHODS To this purpose we compared renal resistive index and blood creatinine obtained from 28 nephropathic patients at their first control, with blood creatinine values after a 3-year follow-up period. Using a linear regression test, we found a strong correlation between the initial value of resistive index and the value of creatinine variation (p = 0.006). RESULTS All of the patients with normal resistive index at the beginning maintained a stable renal function. Conversely, the patients with high resistive index at their first control showed a progressive renal failure. CONCLUSION Our study shows the reliability of resistive index in the prognostic evaluation of renal outcome.
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Calza L, Manfredi R, Marinacci G, Fortunato L, Chiodo F. Liver abscess caused by Stenotrophomonas (Xanthomonas) maltophilia in a patient with AIDS. AIDS 2001; 15:2465-7. [PMID: 11774837 DOI: 10.1097/00002030-200112070-00022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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97
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Calza L, Marinacci G, Manfredi R, Colangeli V, Fortunato L, Chiodo F. Pentamidine isethionate as treatment and secondary prophylaxis for disseminated cutaneous leishmaniasis during HIV infection: case report. J Chemother 2001; 13:653-7. [PMID: 11806628 DOI: 10.1179/joc.2001.13.6.653] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Leishmaniasis is emerging as a common and serious opportunistic infection in HIV-infected patients in endemic areas (such as Mediterranean countries), and may occur with various clinical presentations, ranging from typical visceral forms to atypical cases, including cutaneous disease. Although pentavalent antimony compounds have been the mainstay of antileishmanial treatment for half a century, new drugs seem today reliable, including liposomal amphotericin B and pentamidine isethionate. However, the most effective therapy is still unknown. An HIV-infected i.v. drug abuser patient with a very uncommon disseminated cutaneous leishmaniasis, following an initial visceral disease, is described. Primary and recurrent visceral forms of protozoan infection have been treated with liposomal amphotericin B, while pentamidine isethionate was successfully employed as treatment for subsequent cutaneous relapse and as secondary prophylaxis.
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Re MC, Borderi M, Monari P, Bon I, Gorini R, Gibellini D, Verucchi G, Fortunato L, Chiodo F, La Placa M. Prevalence of multiple dideoxynucleoside analogue resistance (MddNR) in a cohort of Italian HIV-1 seropositive patients extensively treated with antiretroviral drugs. Int J Antimicrob Agents 2001; 18:519-23. [PMID: 11738338 DOI: 10.1016/s0924-8579(01)00440-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
As the emergence of highly resistant virus might compromise antiretroviral regimens in HIV-1 infected patients, a constant analysis of genotypic mutations should be performed to establish the magnitude of mutation prevalence and gauge their impact in patients treated extensively with combination therapy. The frequency of multiple dideoxynucleoside analogue resistance (MddNR) was evaluated in a group of Italian HIV-1 seropositive patients who failed to respond to therapy despite a long-lasting drug treatment. Results showed the presence of one or more mutations (A62V, V75I, F77L, F116Y and Q151M) able to confer resistance to all NRTIs in a relatively high percentage (7.9%) of patients enrolled in the study. Moreover, a significantly lower HIV-1 viral replication in patients with MddNR, suggested the importance of monitoring HIV-1 subjects not only by viral load, but also by drug resistance testing, so that a correct drug regimen may be chosen.
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Fortunato L, Benzoni C, Amini M, Alessi G, Manni C, Andrich R, Di Nardo A, Crenca F, Bianca S, Farina M, Vitelli CE. [Sentinel lymph node for breast cancer: remove less to know more]. MINERVA CHIR 2001; 56:439-49. [PMID: 11568718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
BACKGROUND Our aim was to study the value of sentinel lymph node (SLN) biopsy in patients with breast cancer seen at a community hospital. METHODS Consecutive cases receiving primary treatment for unicentric breast cancer less than 3 cm in diameter were prospectively studied from January 1999 to July 2000. All patients signed a detailed informed consent. The majority of patients (89%) underwent a combined technique of intradermal injection of 0.3-1.2 mCi of (99)Tc and 1-3 cc of Patent Blue at the biopsy site. Intraoperative localization was performed with a hand-held gamma probe. The first 15 patients underwent routine back-up lymphadenectomy. Thereafter, only patients with positive SLN, suspicious findings, or personal preference underwent formal axillary dissection. RESULTS One hundred eight cases were included in the study with a median age of 61 years and a median diameter of the breast tumor of 1.5 cm. Success rate for identification of SLN was 94% (101/108 cases). A total of 917 additional lymph nodes were removed after SLN biopsy (median 6.5 lymph nodes/patient). Correlation between SLN and the final axillary status was 98%. In 20/36 patients (61%) with positive axillary status the sentinel lymph node was the only positive one. Ten patients had only microscopic foci of cancer found in the SLN. Sixty-seven patients (62%) could have avoided axillary dissection becouse the SLN was found, it was negative, and there were no other intraoperative suspicious findings. CONCLUSIONS SLN biopsy is accurate and easily reproduced. Our data confirms that the majority of breast cancer patients may no longer need routine axillary lymphadenectomy.
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100
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Gherardini G, Thomas R, Basoccu G, Zaccheddu R, Fortunato L, Cortino P, Evans GR, Matarasso A, D'Aiuto M, D'Aiuto G. Immediate breast reconstruction with the transverse rectus abdominis musculocutaneous flap after skin-sparing mastectomy. Int Surg 2001; 86:246-51. [PMID: 12056470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
Immediate breast reconstruction with the transverse rectus abdominis musculocutaneous (TRAM) flap after skin-sparing mastectomy is becoming an increasingly performed procedure in patients with ductal carcinoma in situ, early invasive breast cancer, and prophylactic mastectomy. Through a periareolar approach, it is possible to remove the breast parenchyma along with the nipple areola complex, preserving almost all the original skin envelope and the inframmamary fold. The TRAM flap is used to recreate the volume and shape of the original breast. This technique has higher quality and easier reconstruction. The major disadvantages, extensive scar and donor site skin color mismatch, are reduced to a minimum level because the former is limited at the natural border of the nipple areola and the latter can be effectively concealed with proper nipple reconstruction. Thirty-one patients with a mean age of 39 years (range, 26-50 years) who had undergone unilateral or bilateral mastectomy for early breast cancer and immediate breast reconstruction with the pedicled TRAM flap were retrospectively reviewed. Requirements for the skin-sparing mastectomy technique include suitability of donor site tissue for autologous tissue, early breast cancer or ductal carcinoma in situ, and adequate size and shape matching of the contralateral breast. There was no observed local recur- rence during the follow-up period (mean, 20 months; range, 11-30 months). Complications at the recipient site include mastectomy skin flap partial necrosis in 2 patients and cellulitis of the transferred flap in 1 patient. No total or partial flap necrosis was observed. One patient developed abdominal bulging 1 month after the operation, during the administration of chemotherapy. All reconstruction was considered very satisfactory from an aesthetic perspective by the surgeon and the patient. The nicer aesthetic result with oncological safety is achieved with immediate breast reconstruction with the TRAM flap after skin-sparing mastectomy. The risk of local recurrence is not higher compared with more radical surgical techniques.
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