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Novara G, Zattoni F, Zecchini G, Aceti A, Pellizzari A, Ferraioli G, Cobacchini C, Taverna A, Sattin F, Carletti F, La Bombarda G, Lacognata CS, Lauro A, Gardiman M, Morlacco A, Betto G, Dal Moro F. Role of targeted biopsy, perilesional biopsy, random biopsy, and their combination in the detection of clinically significant prostate cancer by mpMRI/transrectal ultrasonography fusion biopsy in confirmatory biopsy during active surveillance program. Prostate Cancer Prostatic Dis 2024; 27:129-135. [PMID: 37828151 DOI: 10.1038/s41391-023-00733-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 09/07/2023] [Accepted: 09/28/2023] [Indexed: 10/14/2023]
Abstract
BACKGROUND Based on the findings of different trials in biopsy naïve patients, target biopsy (TB) plus random biopsy (RB) during mpMRI-guided transrectal ultrasound fusion biopsy (FB) are often also adopted for the biopsy performed during active surveillance (AS) programs. At the moment, a clear consensus on the extent and modalities of the procedure is lacking. OBJECTIVE To evaluate the increase in diagnostic accuracy achieved by perilesional biopsy (PL) and different RB schemes during FB performed in AS protocol. DESIGN, SETTING, AND PARTICIPANTS We collected prospectively the data of 112 consecutive patients with low- or very-low-risk prostate cancer; positive mpMRI underwent biopsy at a single academic institution in the context of an AS protocol. INTERVENTION(S) mpMRI/transrectal US FB with Hitachi RVS system with 3 TB and concurrent transrectal 24-core RB. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS The diagnostic yield of the different possible biopsy schemes (TB only; TB + 4 perilesional (PL) cores; TB + 12-core RB; TB + 24-core RB) was compared by the McNemar test. Univariable and multivariable regression analyses were adopted to identify predictors of any cancer, Gleason grade group (GGG) ≥2 cancers, and the presence of GGG≥2 cancers in the larger schemes only. RESULTS AND LIMITATIONS The detection rate of GGG ≥2 cancers increased to 30%, 39%, and 49% by adding 4 PL cores, 14, and 24 RB cores, respectively, to TB cores (all p values <0.01). On the whole, TB alone, 14-core RB, and 24-core-RB identified 38%, 47%, and 56% of all the GGG ≥2 cancers. Such figures increased to 62% by adding to TB 4 PL cores, and to 80% by adding 14 RB cores. Most of the differences were observed in PI-RADS 4 lesions. CONCLUSIONS We found that PL biopsy increased the detection rate of GGG ≥2 cancers as compared with TB alone. However, the combination of those cores missed a large percentage of the CS cancers identified with larger RB cores, including a 20% of CS cancers diagnosed only by the combination of TB plus 24-core RB.
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Affiliation(s)
- Giacomo Novara
- Department of Surgery, Oncology, and Gastroenterology - Urology Clinic, University of Padua, Padua, Italy.
| | - Fabio Zattoni
- Department of Surgery, Oncology, and Gastroenterology - Urology Clinic, University of Padua, Padua, Italy
| | - Giovanni Zecchini
- Department of Surgery, Oncology, and Gastroenterology - Urology Clinic, University of Padua, Padua, Italy
| | - Alberto Aceti
- Department of Surgery, Oncology, and Gastroenterology - Urology Clinic, University of Padua, Padua, Italy
| | - Anna Pellizzari
- Department of Surgery, Oncology, and Gastroenterology - Urology Clinic, University of Padua, Padua, Italy
| | - Giordana Ferraioli
- Department of Surgery, Oncology, and Gastroenterology - Urology Clinic, University of Padua, Padua, Italy
| | - Claudia Cobacchini
- Department of Surgery, Oncology, and Gastroenterology - Urology Clinic, University of Padua, Padua, Italy
| | - Alessandra Taverna
- Department of Surgery, Oncology, and Gastroenterology - Urology Clinic, University of Padua, Padua, Italy
| | - Francesca Sattin
- Department of Surgery, Oncology, and Gastroenterology - Urology Clinic, University of Padua, Padua, Italy
| | - Filippo Carletti
- Department of Surgery, Oncology, and Gastroenterology - Urology Clinic, University of Padua, Padua, Italy
| | - Giulia La Bombarda
- Department of Surgery, Oncology, and Gastroenterology - Urology Clinic, University of Padua, Padua, Italy
| | | | - Alberto Lauro
- Radiology Unit, University Hospital of Padua, Padua, Italy
| | - Marina Gardiman
- Surgical Pathology Unit, Department of Medicine, University Hospital of Padua, Padua, Italy
| | - Alessandro Morlacco
- Department of Surgery, Oncology, and Gastroenterology - Urology Clinic, University of Padua, Padua, Italy
| | - Giovanni Betto
- Department of Surgery, Oncology, and Gastroenterology - Urology Clinic, University of Padua, Padua, Italy
| | - Fabrizio Dal Moro
- Department of Surgery, Oncology, and Gastroenterology - Urology Clinic, University of Padua, Padua, Italy
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Nazzani S, Catanzaro M, Biasoni D, Maccauro M, Stagni S, Torelli T, Macchi A, Bernasconi V, Taverna A, Sessa D, Lorenzoni A, Piva L, Lanocita R, Cascella T, Cattaneo L, Montanari E, Salvioni R, Nicolai N. Bilateral inguinal lymph-node dissection vs. unilateral inguinal lymph-node dissection and dynamic sentinel node biopsy in clinical N1 squamous cell carcinoma of the penis. Urol Oncol 2023; 41:210.e1-210.e8. [PMID: 36868883 DOI: 10.1016/j.urolonc.2023.02.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 01/10/2023] [Accepted: 02/06/2023] [Indexed: 03/05/2023]
Abstract
INTRODUCTION To evaluate the role of unilateral inguinal lymph-node dissection (ILND) plus contralateral dynamic sentinel node biopsy (DSNB) vs. bilateral ILND in clinical N1 (cN1) penile squamous cell carcinoma (peSCC) patients. MATERIAL AND METHODS Within our institutional database (1980-2020, included), we identified 61 consecutive cT1-4 cN1 cM0 patients with histological confirmed peSCC who underwent either unilateral ILND plus DSNB (26) or bilateral ILND (35). RESULTS Median age was 54 years (Interquartile range [IQR]: 48-60 years). Median follow-up was 68 months (IQR 21-105 months). Most patients had pT1 (23 %) or pT2 (54.1%), as well as G2 (47.5%) or G3 (23%) tumors, while lymphovascular invasion (LVI) was present in 67.1% of cases. Considering a cN1 and a cN0 groin, overall 57 out of 61 patients (93.5%) had nodal disease in the cN1 groin. Conversely, only 14 out of 61 patients (22.9%) had nodal disease in the cN0 groin. 5-year IR-free survival was 91% (Confidence interval [CI] 80%-100%) for bilateral ILND group and 88% (CI 73%-100%) for the ipsilateral ILND plus DSNB group (P-value 0.8). Conversely, 5-year CSS was 76% (CI 62%-92%) for bilateral ILND group and 78% (CI 63%-97%) for the ipsilateral ILND plus contralateral DSNB group (P-value 0.9). CONCLUSIONS In patients with cN1 peSCC the risk of occult contralateral nodal disease is comparable to cN0 high risk peSCC and the gold standard, namely bilateral ILND, may be replaced by unilateral ILND and contralateral DSNB without affecting positive node detection, IRRs and CSS.
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Affiliation(s)
- Sebastiano Nazzani
- Urologic Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy; Università degli Studi di Milano, Italy.
| | - Mario Catanzaro
- Urologic Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Davide Biasoni
- Urologic Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Marco Maccauro
- Nuclear Medicine Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Silvia Stagni
- Urologic Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Tullio Torelli
- Urologic Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Alberto Macchi
- Urologic Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Valentina Bernasconi
- Urologic Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Alessandra Taverna
- Urologic Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Dario Sessa
- Urologic Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Alice Lorenzoni
- Nuclear Medicine Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Luigi Piva
- Urologic Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Rodolfo Lanocita
- Radiology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Tommaso Cascella
- Radiology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Laura Cattaneo
- Pathology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Emanuele Montanari
- Urology Department, IRCCS Policlinico Ca' Granda, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy; Università degli Studi di Milano, Italy
| | - Roberto Salvioni
- Urologic Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Nicola Nicolai
- Urologic Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
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Novara G, Zecchini G, Spagna S, Taverna A, Aiello G, Lauro A, Lacognata C, Gardiman M, Calpista A, Ruggera L, Morlacco A, Dal Moro F. Role of target biopsy, perilesional biopsy, and random biopsy in the detection of clinically significant prostate cancer by mpMRI-guided transrectal ultrasound fusion biopsy during active surveillance protocol. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00368-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Mancini M, Nguyen AAL, Taverna A, Beltrami P, Zattoni F, Dal Moro F. Successful Multidisciplinary Repair of Severe Bilateral Uretero-Enteric Stricture with Inflammatory Reaction Extending to the Left Iliac Artery, after Robotic Radical Cystectomy and Intracorporeal Ileal Neobladder. Curr Oncol 2021; 29:155-162. [PMID: 35049688 PMCID: PMC8774511 DOI: 10.3390/curroncol29010014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 12/27/2021] [Accepted: 12/28/2021] [Indexed: 11/26/2022] Open
Abstract
Uretero-enteric anastomotic strictures (UES) after robot-assisted radical cystectomy (RARC) represent the main cause of post-operative renal dysfunction. The gold standard for treatment of UES is open uretero-ileal reimplantation (UIR), which is often a challenging and complex procedure associated with significant morbidity. We report a challenging case of long severe bilateral UES (5 cm on the left side, 3 cm on the right side) after RARC in a 55 years old male patient who was previously treated in another institution and who came to our attention with kidney dysfunction and bilateral ureteral stents from the previous two years. Difficult multiple ureteral stent placement and substitutions had been previously performed in another hospital, with resulting urinary leakage. An open surgical procedure via an anterior transperitoneal approach was performed at our hospital, which took 10 h to complete, given the massive intestinal and periureteral adhesions, which required very meticulous dissection. A vascular surgeon was called to repair an accidental rupture that had occurred during the dissection of the external left iliac artery, involved in the extensive periureteral inflammatory process. Excision of a segment of the external iliac artery was accomplished, and an interposition graft using a reversed saphenous vein was performed. Bilateral ureteroneocystostomy followed, which required, on the left side, the interposition of a Casati-Boari flap harvested from the neobladder, and on the right side a neobladder-psoas-hitching procedure with intramucosal direct ureteral reimplantation. The patient recovered well and is currently in good health, as determined at his recent 24-month follow-up visit. No signs of relapse of the strictures or other complications were detected. Bilateral ureteral reimplantation after robotic radical cystectomy is a complex procedure that should be restricted to high-volume centers, where multidisciplinary teams are available, including urologists, endourologists, and general and vascular surgeons.
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Affiliation(s)
- Mariangela Mancini
- Urological Clinic, University Hospital of Padova, 35121 Padova, Italy; (A.A.L.N.); (A.T.); (P.B.); (F.Z.); (F.D.M.)
- Department of Surgical, Oncological and Gastroenterological Sciences, University of Padova, 35121 Padova, Italy
- Correspondence:
| | - Alex Anh Ly Nguyen
- Urological Clinic, University Hospital of Padova, 35121 Padova, Italy; (A.A.L.N.); (A.T.); (P.B.); (F.Z.); (F.D.M.)
- Department of Surgical, Oncological and Gastroenterological Sciences, University of Padova, 35121 Padova, Italy
| | - Alessandra Taverna
- Urological Clinic, University Hospital of Padova, 35121 Padova, Italy; (A.A.L.N.); (A.T.); (P.B.); (F.Z.); (F.D.M.)
- Department of Surgical, Oncological and Gastroenterological Sciences, University of Padova, 35121 Padova, Italy
| | - Paolo Beltrami
- Urological Clinic, University Hospital of Padova, 35121 Padova, Italy; (A.A.L.N.); (A.T.); (P.B.); (F.Z.); (F.D.M.)
- Department of Surgical, Oncological and Gastroenterological Sciences, University of Padova, 35121 Padova, Italy
| | - Filiberto Zattoni
- Urological Clinic, University Hospital of Padova, 35121 Padova, Italy; (A.A.L.N.); (A.T.); (P.B.); (F.Z.); (F.D.M.)
- Department of Surgical, Oncological and Gastroenterological Sciences, University of Padova, 35121 Padova, Italy
| | - Fabrizio Dal Moro
- Urological Clinic, University Hospital of Padova, 35121 Padova, Italy; (A.A.L.N.); (A.T.); (P.B.); (F.Z.); (F.D.M.)
- Department of Surgical, Oncological and Gastroenterological Sciences, University of Padova, 35121 Padova, Italy
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Taverna A, Lagger C, Maggioni T, Reyna P, Lovrich G, Tatián M. Ascidian distribution provides new insights to help define the biogeographic provinces in the South American Region. Polar Biol 2018. [DOI: 10.1007/s00300-018-2272-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Roesch C, Lundsgaard-Hansen B, Vonlanthen P, Taverna A, Seehausen O. Experimental evidence for trait utility of gill raker number in adaptive radiation of a north temperate fish. J Evol Biol 2013; 26:1578-87. [DOI: 10.1111/jeb.12166] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2012] [Revised: 03/07/2013] [Accepted: 03/15/2013] [Indexed: 11/28/2022]
Affiliation(s)
- C. Roesch
- Division of Aquatic Ecology & Evolution; Institute of Ecology and Evolution; University of Bern; Bern Switzerland
- Department of Fish Ecology & Evolution; Eawag Swiss Federal Institute of Aquatic Science and Technology; Centre of Ecology, Evolution and Biogeochemistry; Kastanienbaum Switzerland
| | - B. Lundsgaard-Hansen
- Division of Aquatic Ecology & Evolution; Institute of Ecology and Evolution; University of Bern; Bern Switzerland
- Department of Fish Ecology & Evolution; Eawag Swiss Federal Institute of Aquatic Science and Technology; Centre of Ecology, Evolution and Biogeochemistry; Kastanienbaum Switzerland
| | - P. Vonlanthen
- Department of Fish Ecology & Evolution; Eawag Swiss Federal Institute of Aquatic Science and Technology; Centre of Ecology, Evolution and Biogeochemistry; Kastanienbaum Switzerland
| | - A. Taverna
- Department of Fish Ecology & Evolution; Eawag Swiss Federal Institute of Aquatic Science and Technology; Centre of Ecology, Evolution and Biogeochemistry; Kastanienbaum Switzerland
| | - O. Seehausen
- Division of Aquatic Ecology & Evolution; Institute of Ecology and Evolution; University of Bern; Bern Switzerland
- Department of Fish Ecology & Evolution; Eawag Swiss Federal Institute of Aquatic Science and Technology; Centre of Ecology, Evolution and Biogeochemistry; Kastanienbaum Switzerland
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Lundsgaard-Hansen B, Matthews B, Vonlanthen P, Taverna A, Seehausen O. Adaptive plasticity and genetic divergence in feeding efficiency during parallel adaptive radiation of whitefish (Coregonus
spp.). J Evol Biol 2013; 26:483-98. [DOI: 10.1111/jeb.12063] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2012] [Accepted: 10/25/2012] [Indexed: 11/29/2022]
Affiliation(s)
- B. Lundsgaard-Hansen
- Division of Aquatic Ecology & Evolution; Institute of Ecology and Evolution; University of Bern; Bern Switzerland
- Department of Fish Ecology & Evolution; Centre of Ecology, Evolution and Biogeochemistry; Eawag Swiss Federal Institute of Aquatic Science and Technology; Kastanienbaum Switzerland
| | - B. Matthews
- Department of Aquatic Ecology; Centre of Ecology, Evolution and Biogeochemistry; Eawag Swiss Federal Institute of Aquatic Science and Technology; Kastanienbaum Switzerland
| | - P. Vonlanthen
- Department of Fish Ecology & Evolution; Centre of Ecology, Evolution and Biogeochemistry; Eawag Swiss Federal Institute of Aquatic Science and Technology; Kastanienbaum Switzerland
| | - A. Taverna
- Department of Fish Ecology & Evolution; Centre of Ecology, Evolution and Biogeochemistry; Eawag Swiss Federal Institute of Aquatic Science and Technology; Kastanienbaum Switzerland
| | - O. Seehausen
- Division of Aquatic Ecology & Evolution; Institute of Ecology and Evolution; University of Bern; Bern Switzerland
- Department of Fish Ecology & Evolution; Centre of Ecology, Evolution and Biogeochemistry; Eawag Swiss Federal Institute of Aquatic Science and Technology; Kastanienbaum Switzerland
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Keller I, Taverna A, Seehausen O. Evidence of neutral and adaptive genetic divergence between European trout populations sampled along altitudinal gradients. Mol Ecol 2011; 20:1888-904. [PMID: 21418113 DOI: 10.1111/j.1365-294x.2011.05067.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Species with a wide geographical distribution are often composed of distinct subgroups which may be adapted to their local environment. European trout (Salmo trutta species complex) provide an example of such a complex consisting of several genetically and ecologically distinct forms. However, trout populations are strongly influenced by human activities, and it is unclear to what extent neutral and adaptive genetic differences have persisted. We sampled 30 Swiss trout populations from heterogeneous environments along replicated altitudinal gradients in three major European drainages. More than 850 individuals were genotyped at 18 microsatellite loci which included loci diagnostic for evolutionary lineages and candidate markers associated with temperature tolerance, reproductive timing and immune defence. We find that the phylogeographic structure of Swiss trout populations has not been completely erased by stocking. Distinct genetic clusters corresponding to the different drainages could be identified, although nonindigenous alleles were clearly present, especially in the two Mediterranean drainages. We also still detected neutral genetic differentiation within rivers which was often associated with the geographical distance between populations. Five loci showed evidence of divergent selection between populations with several drainage-specific patterns. Lineage-diagnostic markers, a marker linked to a quantitative trait locus for upper temperature tolerance in other salmonids and a marker linked to the major histocompatibility class I gene were implicated in local adaptation and some patterns were associated with altitude. In contrast, tentative evidence suggests a signal of balancing selection at a second immune relevant gene (TAP2). Our results confirm the persistence of both neutral and potentially adaptive genetic differences between trout populations in the face of massive human-mediated dispersal.
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Affiliation(s)
- I Keller
- Department of Fish Ecology and Evolution, EAWAG Swiss Federal Institute of Aquatic Science and Technology, Center of Ecology, Evolution and Biochemistry, Seestrasse 79, CH-6047 Kastanienbaum, Switzerland.
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Abstract
This article takes parental perception as the starting point of an analysis of the relationship between ill children, their families, and their doctors in the handling of a child's illness. A modified version of Creer, Marion, and Creer's Asthma Problem Behavior Checklist, adapted to suit Italian conditions, was used. The questionnaire was given to a sample of 460 parents of 230 preadolescent children. The sample was divided into two groups: The first sample was comprised of 84 parents of 42 preadolescent children with atopic symptoms (asthma, bronchitis, or hay fever), and the second sample was comprised of 376 parents of 188 preadolescents who had never had either atopic disturbances or any other serious disease. The results showed that both groups of parents felt their children were capable of autonomously managing their disease, and that they see medical facilities as their primary resource. Children were not perceived as being altered by their illness, although their illness undoubtedly affected family relationships; this was particularly true in the case of families with members who experience atopic problems. The factors causing the greatest difficulties were: disagreements over treatment, anxiety caused by the disease, and the sacrifices made by family members as a result of illness.
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Affiliation(s)
- G Peri
- Department of Psychology, Catholic University of Milan, Italy
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