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Vingiani S, Buttafuoco G, Fagnano M, Guarino A, Perreca C, Albanese S. A multisensor approach coupled with multivariate statistics and geostatistics for assessing the status of land degradation: The case of soils contaminated in a former outdoor shooting range. Sci Total Environ 2024:172398. [PMID: 38677437 DOI: 10.1016/j.scitotenv.2024.172398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 04/03/2024] [Accepted: 04/09/2024] [Indexed: 04/29/2024]
Abstract
Soil contamination in outdoor shooting ranges (OSRs) is a major threat for human health, particularly when, after the end of activities, the land is used for recreational areas or agricultural production. The status of land degradation of an OSR in southern Italy was assessed using a multisensor approach. It was based on: i) proximal sensors, including electromagnetic induction (EMI) for measuring soil electrical conductivity (ECa) and magnetic susceptibility (MSa), γ-ray spectrometry for K, eU and eTh analyses and ultrasonic penetrometry detecting cone index (CI) data representative of soil's strength, ii) field surveys on soil thickness (ST), and iii) laboratory analyses of potentially-toxic-elements (PTEs) by portable X-ray fluorescence spectrometry and polycyclic aromatic hydrocarbons (PAHs) by gas-chromatography. Spatial variability of measurements was modelled and mapped using geostatistical methods. The most densely measured covariate (i.e., the ECa of the topsoil) was used within kriging with external drift to improve the PTEs predictions. The PTEs maps were complemented by maps of spatial uncertainty. A robust multivariate principal component analysis (rPCA) was applied to proximal sensor and laboratory data and allowed to identify associations of PAHs, lead, CI with the topsoil ECa along the first component (PC1), highlighting the correlation between land anthropogenic effects and EMI measures; while the association between the ST (estimating the depth of underground travertine hard-layers) and the bottom soil ECa and MSa along the second component (PC2) evidenced the influence of soil stratigraphy on the EMI measures. This study demonstrates that the simultaneous use of different proximal sensors associated with laboratory analysis can allow to assess and model the spatial variability of the land degradation status of an OSR, including soil compaction, organic and inorganic contamination. The correlation between EMI data with the PTEs content highlights the potential of this technique in the field of soil contamination.
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Affiliation(s)
- S Vingiani
- Department of Agricultural Sciences, University of Naples Federico II, Portici, NA, Italy
| | - G Buttafuoco
- National Research Council of Italy, Institute for Agriculture and Forestry Systems in the Mediterranean, Rende, CS, Italy
| | - M Fagnano
- Department of Agricultural Sciences, University of Naples Federico II, Portici, NA, Italy
| | - A Guarino
- Department of Earth, Environmental and Resources Sciences, University of Naples Federico II, Naples, Italy
| | - C Perreca
- Department of Agricultural Sciences, University of Naples Federico II, Portici, NA, Italy.
| | - S Albanese
- Department of Earth, Environmental and Resources Sciences, University of Naples Federico II, Naples, Italy
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Esposito S, Pagliano P, De Simone G, Guarino A, Pan A, Brambilla P, Mastroianni C, Lichtner M, Brugnaro P, Carretta A, Santantonio T, Brindicci G, Carrega G, Montagnani F, Lapadula G, Spolti A, Luzzati R, Schiaroli E, Scaglione V, Pallotto C, Tacconi D, Quintieri F, Trecarichi E. In-label, off-label prescription, efficacy and tolerability of dalbavancin: report from a National Registry. Infection 2024:10.1007/s15010-024-02176-2. [PMID: 38324144 DOI: 10.1007/s15010-024-02176-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 01/04/2024] [Indexed: 02/08/2024]
Abstract
PURPOSE Although dalbavancin is currently approved for the treatment of ABSSIs, several studies suggest its efficacy and tolerance as long-term therapy for other off-label indications requiring prolonged intravenous antibiotic administration. METHODS We conducted a prospective nationwide study of dalbavancin use in real-life settings for both approved and off-label indications analysing for each case the clinical and microbiological characteristics of infection the efficacy and safety of treatments. RESULTS During the study period (from December 2018 to July 2021), the ID specialists from 14 different centres enrolled 223 patients treated with dalbavancin [141 males (63%) and 82 females (37%); male/female ratio 1.72; mean age 59 (SD 17.2) years, (range 15-96). Most patients in the study population (136/223; 61.0%) came from community rather than health care facilities and most of them were visited in Infectious Diseases wards (93/223; 41.7%) and clinics (55/223; 24.7%) even though some patients were cured in other settings, such as surgery wards (18/223; 8.1%), orthopaedic wards (11/223; 4.9%), Emergency Rooms (7/223; 3.1%) and non-surgical other than ID wards (6/223; 2.7%). The most common ID diagnoses were osteomyelitis (44 cases/223; 19.7%; of which 29 acute and 15 chronic osteomyelitis), cellulitis (28/223; 12.5%), cutaneous abscess (23/223; 10.3%), orthopaedic prosthesis-associated infection (22/223; 9.9%), surgical site infection (20/223; 9.0%) and septic arthritis (15/223; 6.7%). CONCLUSION In conclusion, by virtue of its PK/PD properties, dalbavancin represents a valuable option to daily in-hospital intravenous or outpatient antimicrobial regimens also for off-label indications requiring a long-term treatment of Gram-positive infections.
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Affiliation(s)
- Silvano Esposito
- Department of Infectious Diseases, University of Salerno, Salerno, Italy.
| | - Pasquale Pagliano
- Department of Infectious Diseases, University of Salerno, Salerno, Italy
| | - Giuseppe De Simone
- Department of Infectious Diseases, University of Salerno, Salerno, Italy
| | - Amedeo Guarino
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Angelo Pan
- Department of Infectious Diseases, Istituti Ospitalieri of Cremona, Cremona, Italy
| | - Paola Brambilla
- Department of Infectious Diseases, Istituti Ospitalieri of Cremona, Cremona, Italy
| | - Claudio Mastroianni
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
| | - Miriam Lichtner
- Department of Public Health and Infectious Diseases, Sapienza University, Latina, Italy
| | - Pierluigi Brugnaro
- Infectious Diseases Department, Ospedale Civile "SS. Giovanni E Paolo", Venice, Italy
- Department of Infectious Diseases, University Hospital "Ospedali Riuniti" of Foggia, Foggia, Italy
| | - Anna Carretta
- Infectious Diseases Department, Ospedale Civile "SS. Giovanni E Paolo", Venice, Italy
- Department of Infectious Diseases, University Hospital "Ospedali Riuniti" of Foggia, Foggia, Italy
| | - Teresa Santantonio
- Infectious Diseases Department, Ospedale Civile "SS. Giovanni E Paolo", Venice, Italy
- Department of Infectious Diseases, University Hospital "Ospedali Riuniti" of Foggia, Foggia, Italy
| | | | - Giuliana Carrega
- Infectious Diseases Unit, Santa Maria Della Misericordia Hospital, Albenga, Savona, Italy
| | | | | | - Anna Spolti
- Infectious Diseases Unit, San Gerardo Hospital, Monza, Italy
| | | | | | - Vittoria Scaglione
- Department of Infectious Diseases, University of Perugia, Perugia, Italy
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Dejour DH, Pineda T, Guarino A, Dan MJ, Giovannetti de Sanctis E. Medial Closing-Wedge Patellar Osteotomy in Patients With Patellofemoral Instability. Arthrosc Tech 2024; 13:102848. [PMID: 38435268 PMCID: PMC10907901 DOI: 10.1016/j.eats.2023.09.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 09/23/2023] [Indexed: 03/05/2024] Open
Abstract
Trochlear dysplasia is the main anatomical risk factor for objective patellar instability. Surgical correction of trochlea dysplasia via a trochleoplasty has been described with good clinical results reported. Concerns remain for who have abnormal patellofemoral tracking post a trochleoplasty due to incongruence between the two articulating surfaces. We described a medial closing wedge patellar osteotomy to improve congruency of the patellofemoral joint post-trochleoplasty.
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Affiliation(s)
| | - Tomas Pineda
- Lyon-Ortho-Clinic: Clinique de la Sauvegarde, Lyon, France
| | - Amedeo Guarino
- Lyon-Ortho-Clinic: Clinique de la Sauvegarde, Lyon, France
| | - Michael J. Dan
- Lyon-Ortho-Clinic: Clinique de la Sauvegarde, Lyon, France
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de Giovanni R, Guarino A, Rossi V, Bruzzese D, Mariconda M, Cozzolino A. Is the Number of Citations Related to the Study Methodology in Shoulder Arthroplasty Literature? A Bibliometric and Statistical Analysis of Current Evidence. J Shoulder Elb Arthroplast 2024; 8:24715492231223346. [PMID: 38186673 PMCID: PMC10771075 DOI: 10.1177/24715492231223346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 11/24/2023] [Accepted: 12/11/2023] [Indexed: 01/09/2024] Open
Abstract
Background We reviewed the shoulder arthroplasty (SA) literature to correlate citations, methodological characteristics and quality of most-cited articles in this field. We hypothesized that a greater number of citations would be found for high-quality clinical studies. Methods We searched the Web of Knowledge database for the 50 most-cited articles about SA and collected author name, publication year, country of origin, journal, article type, level of evidence (LoE), subject of paper, type of arthroplasty and metrics (number of citations and citation rate). Coleman Methodology Score (CMS) was computed for clinical articles. Statistical analysis of variance and correlation coefficients were used to investigate the relationship between different variables. Results Out of the selected 50 studies on SA, 26% were nonclinical. There were 15,393 citations overall (mean 307.8), with a mean 19.5 citations per year (range 48.3-6.7). Thirty or 60% of all articles were LoE IV. All studies were published between 1984 and 2011 in 8 journals. Reverse SA (RSA) was the most common subject (36% of studies). The United States was the country responsible for most contributions (50% of studies). CMS ranged from 81 to 38 (mean 59.6). RSA received the highest number of citations (P < .001), independently from country of origin (P = .137) and LoE (P = .723). CMS correlated with citation rate (r = 0.397; P = .013) and publication year (tau = 0.397; P = .013), but not with LoE (P = .204). Conclusion In SA literature, citation rate positively correlates with methodological quality of a study, independently from publication country and LoE. Among most-cited papers, RSA is the most common standalone subject.
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Affiliation(s)
- Roberto de Giovanni
- Department of Public Health, Orthopedic Unit, “Federico II” University, Naples, Italy
| | - Amedeo Guarino
- Department of Public Health, Orthopedic Unit, “Federico II” University, Naples, Italy
| | - Valentina Rossi
- Department of Public Health, Orthopedic Unit, “Federico II” University, Naples, Italy
| | - Dario Bruzzese
- Department of Public Health, Medical Statistics, “Federico II” University, Naples, Italy
| | - Massimo Mariconda
- Department of Public Health, Orthopedic Unit, “Federico II” University, Naples, Italy
| | - Andrea Cozzolino
- Department of Public Health, Orthopedic Unit, “Federico II” University, Naples, Italy
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Guarino A, Pineda T, Giovannetti de Sanctis E, van Rooij F, Saffarini M, Dejour D. The Original Technique for Tibial Deflexion Osteotomy During Revision Anterior Cruciate Ligament Reconstruction: Surgical Technique. Arthrosc Tech 2024; 13:102824. [PMID: 38312891 PMCID: PMC10837977 DOI: 10.1016/j.eats.2023.08.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 08/27/2023] [Indexed: 02/06/2024] Open
Abstract
The original technique for tibial deflexion osteotomy (TDO) was first described by Henri Dejour during the Lyon knee meeting in 1991 to reduce excessive posterior tibial slope during second revision anterior cruciate ligament reconstruction (ACLR). The technique is nowadays increasingly performed during first-revision ACLR in patients at risk for graft retear. This Technical Note describes and updates the original TDO technique.
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Affiliation(s)
- Amedeo Guarino
- Ramsay Santé, Lyon-Ortho-Clinic, Clinique de la Sauvegarde, Lyon, France
| | - Tomas Pineda
- Ramsay Santé, Lyon-Ortho-Clinic, Clinique de la Sauvegarde, Lyon, France
| | | | | | | | - David Dejour
- Ramsay Santé, Lyon-Ortho-Clinic, Clinique de la Sauvegarde, Lyon, France
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Tetecher L, Cocchiaro T, Guarino A, Giannini T, Maucione S, Di Trani M, Rago R, Ciocca G. Sexological and traumatic aspects in reproductive difficulties: a psychometric study on couples seeking help for infertility. J Endocrinol Invest 2024; 47:179-189. [PMID: 37311972 DOI: 10.1007/s40618-023-02134-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 06/06/2023] [Indexed: 06/15/2023]
Abstract
PURPOSE To investigate the impact of infertility in gender differences on psycho-traumatological, sexological, relational and emotional aspects and gender differences in couples requiring assisted reproductive treatment. METHODS 151 couples were recruited with a mean age of 36.7 ± 4.8 years for women and 39.8 ± 6.6f or men. 43% of women and 34% of men had already received the diagnosis of infertility. To recruited subjects was administered the following psychometric tests: Sexological and Emotional in Infertility questionnaire (SEIq), Arizona Sexual Experience Scale (ASEX), the Orgasmomether and the International Trauma Questionnaire (ITQ). RESULTS There was a significant difference in traumatic symptoms between men and women (t = 5,859, p < 0.05). Gender differences were found in the sexological dimension of the SEIq (t = 7,858, p < .001) and in the total ASEX score (t = 3,979, p < .001). Specifically, significant correlations emerged between the ASEX domains and the emotional and sexological aspects related to infertility only in women. The reaction to the diagnosis was negatively correlated with the emotional area of the couple (r = -0.683, p < .001) and positively with the couple relationship (r = 0.815, p < .001). Multiple regression revealed that the overall functioning of the couple, rather than the single scales, is the main predictor of sexuality (R2 = 0.77). CONCLUSION A clear impact of infertility on the couple's psycho-traumatological, psycho-sexological and relational aspects emerged. It could be useful to promote targeted support interventions on the most compromised areas of couple functioning in assisted reproductive centers.
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Affiliation(s)
- L Tetecher
- Department of Dynamic and Clinical Psychology, and Health Studies, School of Health Psychology, Sapienza University of Rome, Rome, Italy
| | - T Cocchiaro
- Physiopathology of Reproduction and Andrology Unit, Sandro Pertini Hospital, Rome, Italy
| | - A Guarino
- Physiopathology of Reproduction and Andrology Unit, Sandro Pertini Hospital, Rome, Italy
| | - T Giannini
- Section of Sexual Psychopathology, Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Via Degli Apuli, 1, 00185, Rome, Italy
| | - S Maucione
- Section of Sexual Psychopathology, Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Via Degli Apuli, 1, 00185, Rome, Italy
| | - M Di Trani
- Department of Dynamic and Clinical Psychology, and Health Studies, School of Health Psychology, Sapienza University of Rome, Rome, Italy
| | - R Rago
- Physiopathology of Reproduction and Andrology Unit, Sandro Pertini Hospital, Rome, Italy
| | - G Ciocca
- Section of Sexual Psychopathology, Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Via Degli Apuli, 1, 00185, Rome, Italy.
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Marcoccia A, Guarino A, Cocchiaro T, Modesti M, Cianfrocca C, Privitera R, Isabelli S, Vizzini MAS, Rago R, Renzi A, Di Trani M. Psychopathological symptoms and their association with the quality of life and the sexual functioning in women affected by systemic scleroderma: a preliminary investigation. Eur Rev Med Pharmacol Sci 2024; 28:288-297. [PMID: 38235899 DOI: 10.26355/eurrev_202401_34915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
OBJECTIVE This study aimed to investigate the presence of psychopathological symptoms and the relations of these dimensions with the quality of life and sexual function in a group of women affected by systemic scleroderma. SUBJECTS AND METHODS Seventy-one women with systemic scleroderma were invited to participate in the study; 65 agreed to participate, while 6 declined. Four questionnaires were administered to the patients: a specific socio-demographic questionnaire, the Symptom Checklist-90-Revised (SCL-90-R), the Female Sexual Function Index (FSFI), and the Quality-of-Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO-41). RESULTS Of all the participants in this study, 48% of patients showed a clinical score on SCL-90-R Somatization, 45% on depression, and 37% on obsessive-compulsive. As hypothesized, psychopathological symptoms were related to lower quality of life since somatization and depression predicted the total score of health-related quality of life and lower sexual functions, showing a specific effect of depression on sexuality. CONCLUSIONS Our findings highlighted the presence of an association between psychopathological symptoms and reduced sexual functioning and the associations between somatization and the health-related quality of life dimensions in scleroderma patients. Furthermore, our results sustain the importance of also considering the mental health of patients with systemic sclerosis, within an integrated biopsychosocial care model.
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Affiliation(s)
- A Marcoccia
- Department of Medical Area, Vascular Disease and Immunology Unit, Sandro Pertini Hospital, Rome, Italy.
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Cozzolino A, Malfi P, de Giovanni R, Fedele A, Rusconi G, Guarino A, Di Pietto F, Russo R. Computed tomography improves the diagnostic accuracy but not the interobserver reliability of the Boileau classification of proximal humerus fracture sequelae. Shoulder Elbow 2023; 15:634-640. [PMID: 37981965 PMCID: PMC10656970 DOI: 10.1177/17585732221150785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 12/13/2022] [Accepted: 12/13/2022] [Indexed: 11/21/2023]
Abstract
Background The aim of this study was to investigate the impact of computed tomography on the reliability of Boileau classification for proximal humerus fracture sequelae. Methods A prospective study was designed using STARD guidelines. We included all patients diagnosed with proximal humerus fracture sequelae who underwent surgery at our institution between 2017 and 2021. Preoperative radiographs and computed tomography scans were reviewed by three independent observers. Intra- and inter-observer reliability and the diagnostic accuracy of radiographs and computed tomography scans in detecting chronic dislocation, nonunion, and severe greater tuberosity dislocation were assessed. Results Fifty-two patients were included in the study. The overall interobserver agreement was low on both radiographs and computed tomography scans. On radiographic images, we found a sensitivity of 97%, 88.9%, and 84.1%, and a specificity of 58.3%, 40%, and 53.3% to detect chronic dislocation, nonunion, and greater tuberosity dislocation, respectively. On computed tomography scans we reported a sensitivity of 100%, 96.8%, and 93.7%, and a specificity of 91.7%, 86.7%, and 93.3% to detect chronic dislocation, nonunion, and greater tuberosity dislocation, respectively. Discussion Computed tomography scan was more specific than radiographs in the assessment of proximal humerus fracture sequelae. However, even using a three-dimensional evaluation of the deformity, the Boileau classification had a poor interobserver reliability. Level of Evidence I. Testing previously developed diagnostic criteria in a consecutive series of patients and a universally applied "gold standard."
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Affiliation(s)
- Andrea Cozzolino
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | | | - Roberto de Giovanni
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Alfonso Fedele
- Department of Orthopedic Surgery, Pineta Grande Hospital, Castel Volturno, Italy
| | - Giovanni Rusconi
- Department of Orthopedic Surgery, Pineta Grande Hospital, Castel Volturno, Italy
| | - Amedeo Guarino
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Francesco Di Pietto
- Department of Orthopedic Surgery, Pineta Grande Hospital, Castel Volturno, Italy
| | - Raffaele Russo
- Department of Orthopedic Surgery, Pineta Grande Hospital, Castel Volturno, Italy
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Giovannetti de Sanctis E, Guarino A, Pineda T, Demey G, Dejour DH. The Femoral Sulcus Deepening Trochleoplasty of Lyon. Arthrosc Tech 2023; 12:e687-e695. [PMID: 37323784 PMCID: PMC10265532 DOI: 10.1016/j.eats.2023.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 01/18/2023] [Indexed: 06/17/2023] Open
Abstract
The sulcus deepening trochleoplasty procedure has been described for the management of patellofemoral instability in patients with severe trochlear dysplasia. Here, we describe the updated Lyon sulcus deepening trochleoplasty technique. This technique with a stepwise approach allows one to prepare the trochlea, remove the subchondral bone, osteotomize the articular surface, and fix the facets with 3 anchors while minimizing the risk of complications.
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Affiliation(s)
- Edoardo Giovannetti de Sanctis
- Address correspondence to Edoardo Giovannetti de Sanctis, M.D., Lyon-Ortho-Clinic: Clinique de la Sauvegarde, Ramsay Santé, 8, avenue Ben Gourion, 69009 Lyon, France.
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Bernasconi A, Rizzo M, Izzo A, Vallefuoco S, Russo AP, Rossi V, Abate B, Guarino A, Mariconda M. Bösch osteotomy for hallux valgus correction: results at a mean 10-year follow-up. Arch Orthop Trauma Surg 2023; 143:1293-1300. [PMID: 34839385 DOI: 10.1007/s00402-021-04259-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 11/12/2021] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Bösch osteotomy (BO), which is a first metatarsal subcapital osteotomy stabilised with a K-wire, is a surgical option to correct hallux valgus (HV). The aim of this study was to assess the long-term clinical and radiographic results in a cohort of patients treated at our institution with such osteotomy. METHODS In this retrospective monocentric single-surgeon cohort study, we included 58 HVs (46 patients) who underwent HV correction by BO and were followed at a minimum of 7 years. The range of motion (ROM), the American Orthopaedic Foot and Ankle Society's Forefoot scale (AOFAS-FS) and the Visual Analogic Scale (VAS) for pain were recorded. On weightbearing radiographs, the Hallux Valgus Angle (HVA), Intermetatarsal Angle (IMA), the Distal Metatarsal Articular Angle (DMAA), and the Lateral Sesamoid Position (LSP) were measured and compared with pre-operative values. The complication rate and first metatarsophalangeal joint stiffness were also assessed. RESULTS At a mean follow-up of 10 ± 2 (7-17) years, mean ± standard deviation AOFAS-FS and VAS were 89 ± 11 (67-93) and 2.1 ± 2.8 (0-7) points, respectively. In 42 (72%) cases there was no limitation in the choice of footwears. Radiographically, we found a significant improvement in the HVA (from 33.9° ± 6.7 to 18.8° ± 5.6, p < 0.001), in the IMA (14.2° ± 3.1 to 9.4° ± 2.7, p < 0.001), in the DMAA (from 30.3° ± 6.8 to 11.5° ± 5.1, p < 0.001) and in LSP (median value from 3 to 1, p < 0.001). In 36 (62%) cases the ROM was greater than 75° while in 22 (38%) it ranged between 30° and 75°. Minor complications occurred in six (10%) cases, which did not require any further surgery at the longest follow-up. CONCLUSION Bösch technique provided satisfactory clinical and radiographic outcomes in the treatment of hallux valgus which persisted at a mean 10-year follow-up. The complication rate did not differ from more recent techniques described in literature. LEVEL OF EVIDENCE Level IV, retrospective cohort study.
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Affiliation(s)
- Alessio Bernasconi
- Orthopaedic and Traumatology Unit, Department of Public Health, University "Federico II" of Naples, Naples, Italy.
| | - Maria Rizzo
- Orthopaedic and Traumatology Unit, Department of Public Health, University "Federico II" of Naples, Naples, Italy
| | - Antonio Izzo
- Orthopaedic and Traumatology Unit, Department of Public Health, University "Federico II" of Naples, Naples, Italy
| | - Salvatore Vallefuoco
- Orthopaedic and Traumatology Unit, Department of Public Health, University "Federico II" of Naples, Naples, Italy
| | - Anna Paola Russo
- Orthopaedic and Traumatology Unit, Department of Public Health, University "Federico II" of Naples, Naples, Italy
| | - Valentina Rossi
- Orthopaedic and Traumatology Unit, Department of Public Health, University "Federico II" of Naples, Naples, Italy
| | - Biagio Abate
- Orthopaedic and Traumatology Unit, Department of Public Health, University "Federico II" of Naples, Naples, Italy
| | - Amedeo Guarino
- Orthopaedic and Traumatology Unit, Department of Public Health, University "Federico II" of Naples, Naples, Italy
| | - Massimo Mariconda
- Orthopaedic and Traumatology Unit, Department of Public Health, University "Federico II" of Naples, Naples, Italy
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Guarino A, Farinelli L, Iacono V, Cozzolino A, Natali S, Zorzi C, Mariconda M. Long-Term Survival and Predictors of Failure of Opening Wedge High Tibial Osteotomy. Orthop Surg 2023; 15:1002-1007. [PMID: 36782306 PMCID: PMC10102285 DOI: 10.1111/os.13674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 01/13/2023] [Accepted: 01/13/2023] [Indexed: 02/15/2023] Open
Abstract
OBJECTIVE High tibial valgus osteotomy (HTO) is a widely accepted procedure indicated for varus knee with symptomatic osteoarthritis of the medial compartment. However, there is a lack of studies evaluating long term results of this procedure. The primary aim of this study was to evaluate the long-term survival of opening wedge high tibial osteotomy (HTO) for isolated osteoarthritis in the medial compartment of the knee. The secondary objective was to identify independent predictors of conversion to total knee arthroplasty (TKA). METHODS This is a long term retrospective study of 296 cases of open wedge HTOs performed at a single center (level of evidence IV) between January 2005 and August 2015. Opening wedge medial HTO was always performed after diagnostic arthroscopy. Eighty-three percent of the population (233 patients, 247 procedures) was followed up at a mean 11.6 years (6-17) by telephone interview, to evaluate the possible conversion to TKA. Mean age at the index operation was 42.8 years (range 15-70) and most patients were male (70%). Associated procedures (e.g., platelet rich plasma supplementation, microfractures, meniscectomy, etc.) were carried out at the time of the HTO in 80 (32%) cases. Survival of HTO and its association with age, sex, body mass index, smoking habit, preoperative severity of varus deformity, cartilage status at surgery, and associated procedures were evaluated. Kaplan-Meier and Cox regression analyses were performed. RESULTS Thirty-three of the 247 HTOs (13.4%) were converted to knee replacement, with 86.6% of the original procedures surviving at a mean 12-year follow-up. Kaplan-Meier survival estimates at 17 years for HTO were 75.5% (95% confidence interval [CI] 66.7-84.3). There was significant difference (P < 0.001) in the 17-year survival rate between obese (55.5%; 95% CI 35.3-75.6) and non-obese (79.7%; 95% CI 70.1-89.2) patients. The determinants of conversion to knee arthroplasty detected at multivariate Cox regression analysis were body mass index, severity of cartilage degeneration in the medial compartment (Outerbridge grade), and age. CONCLUSION The long-term survival of open wedge HTO for osteoarthritis in the medial compartment of the knee is satisfactory. The risk of conversion to TKA is significantly increased in obese patients. Advanced age and severity of pre-existing cartilage damage may also contribute to the risk of conversion to TKA.
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Affiliation(s)
- Amedeo Guarino
- Department of Public Health, Section of Orthopaedics, Federico II University, Naples, Italy
| | - Luca Farinelli
- Orthopaedic Clinic, Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Ancona, Italy
| | - Venanzio Iacono
- Department of Orthopaedic Surgery, IRCCS Sacro Cuore-Don Calabria in Negrar (VE), Negrar di Valpolicella VR, Italy
| | - Andrea Cozzolino
- Department of Public Health, Section of Orthopaedics, Federico II University, Naples, Italy
| | - Simone Natali
- Department of Orthopaedic Surgery, IRCCS Sacro Cuore-Don Calabria in Negrar (VE), Negrar di Valpolicella VR, Italy
| | - Claudio Zorzi
- Department of Orthopaedic Surgery, IRCCS Sacro Cuore-Don Calabria in Negrar (VE), Negrar di Valpolicella VR, Italy
| | - Massimo Mariconda
- Department of Public Health, Section of Orthopaedics, Federico II University, Naples, Italy
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12
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Costa GG, Franzese V, Cozzolino A, Rizzo M, Cerbasi S, Guarino A, Lepore S, Schiraldi M, Mariconda M. Gamma nail versus percutaneous compression plate for the treatment of intertrochanteric hip fractures: a multicenter pair-matched study. Eur J Orthop Surg Traumatol 2022:10.1007/s00590-022-03441-6. [PMID: 36534367 DOI: 10.1007/s00590-022-03441-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 11/14/2022] [Indexed: 06/17/2023]
Abstract
PURPOSE To compare functional outcomes, complication rates, and survival in patients with intertrochanteric fracture treated with percutaneous compression plate (PCCP) or gamma nail (GN). METHODS A retrospective study of prospectively collected data of patients treated with PCCP or GN for AO/OTA 31.A1 or AO/OTA 31.A2 fractures was conducted. Sixty-eight consecutive patients treated with PCCP between 2018 and 2020 were enrolled and matched with 68 patients with comparable characteristics treated with GN. The activities of daily living (ADL) index and specific scales for walking ability and need for walking aids at 4 months and 1 year after fracture fixation were chosen as primary outcomes. Postoperative complications and one-year survival were recorded and compared between the two groups. RESULTS Walking ability and ADLs index decreased and the need for walking aids increased in both groups compared to the prefracture state at both follow-up intervals (p < 0.001), regardless of the treatment received. There was no difference between the two implants in the rate of implant-related complications. One-year survival rate was 78.9% (95% CI 67.0-86.9) and 82.4% (95% CI 71.0-89.5) in patients undergoing PCCP or GN, respectively, with no significant difference between the two groups. CONCLUSIONS Walking ability, ADLs, complication rate, and 1-year survival are not significantly different when patients undergoing PCCP or GN are compared. The choice of implant may not be decisive for the outcome of treatment of intertrochanteric fractures, provided that stable fixation is ensured.
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Affiliation(s)
- Giovan Giuseppe Costa
- Department of Orthopaedic and Trauma Surgery, "Michele e Pietro Ferrero" Hospital, Verduno, CN, Italy
| | - Vincenzo Franzese
- Department of Orthopaedic and Trauma Surgery, "Michele e Pietro Ferrero" Hospital, Verduno, CN, Italy
| | - Andrea Cozzolino
- Department of Public Health, Section of Orthopaedic and Trauma Surgery, Federico II" University, Via S. Pansini 5, Building 12, 80131, Naples, Italy
| | - Maria Rizzo
- Department of Public Health, Section of Orthopaedic and Trauma Surgery, Federico II" University, Via S. Pansini 5, Building 12, 80131, Naples, Italy
| | - Simone Cerbasi
- Department of Orthopaedic and Trauma Surgery, Ospedali Riuniti, Ancona, Italy
| | - Amedeo Guarino
- Department of Public Health, Section of Orthopaedic and Trauma Surgery, Federico II" University, Via S. Pansini 5, Building 12, 80131, Naples, Italy
| | - Stefano Lepore
- Department of Orthopaedic and Trauma Surgery, "A. Cardarelli" Hospital, Naples, Italy
| | - Marco Schiraldi
- Department of Orthopaedic and Trauma Surgery, "Michele e Pietro Ferrero" Hospital, Verduno, CN, Italy
| | - Massimo Mariconda
- Department of Public Health, Section of Orthopaedic and Trauma Surgery, Federico II" University, Via S. Pansini 5, Building 12, 80131, Naples, Italy.
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13
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Ozma MA, Abbasi A, Asgharzadeh M, Pagliano P, Guarino A, Köse Ş, Samadi Kafil H. Antibiotic therapy for pan-drug-resistant infections. Infez Med 2022; 30:525-531. [PMID: 36482958 PMCID: PMC9715010 DOI: 10.53854/liim-3004-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 11/18/2022] [Indexed: 12/12/2022]
Abstract
Antibiotic resistance occurs when microorganisms resist the drugs used against the infection caused by them and neutralize their effects over time using various mechanisms. These mechanisms include preventing drug absorption, changing drug targets, drug inactivating, and using efflux pumps, which ultimately cause drug resistance, which is named pan-drug-resistant (PDR) infection if it is resistant to all antimicrobial agents. This type of drug resistance causes many problems in society and faces the health system with difficulties; therefore their treatment is crucial and encourages doctors to develop new drugs to treat them. PDR Gram-negative bacteria, including Pseudomonas aeruginosa, Acinetobacter baumannii, Klebsiella pneumoniae, and Escherichia coli are among the most significant resistant bacteria to many antimicrobial agents, and only a limited range of antibiotics, especially synergistically are effective on them. For the therapy of PDR A. baumannii, tigecycline in combination with colestimethate, imipenem, amikacin, and ampicillin-sulbactam are the most effective treatments. The utilization of β-lactamase inhibitors such as ceftolozane-tazobactam, ceftazidime-avibactam, or imipenem-cilastatin-relebactam has the most efficacy against PDR P. aeruginosa. The PDR K. pneumoniae has been treated in the last decades with tigecycline and colistin, but currently, nitrofurantoin, fosfomycin, and pivmecillinam seem to be the most effective agent for the therapy of PDR E. coli. While these drugs impressively struggle with PDR pathogens, due to the daily increase in antibiotic resistance in microorganisms worldwide, there is still an urgent need for the expansion of novel medicines and methods of combating resistance.
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Affiliation(s)
- Mahdi Asghari Ozma
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz,
Iran
| | - Amin Abbasi
- Department of Food Science and Technology, National Nutrition and Food Technology, Research Institute, Faculty of Nutrition Science and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran,
Iran
| | - Mohammad Asgharzadeh
- Biotechnology Research Center, Tabriz University of Medical Sciences, Tabriz,
Iran
| | | | - Amedeo Guarino
- Department of Public Health, University of Naples Federico II, Naples,
Italy
| | - Şükran Köse
- Department of Infectious Diseases and Clinical Microbiology, 9 Eylul University, İzmir,
Turkey
| | - Hossein Samadi Kafil
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz,
Iran
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14
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Sanduzzi Zamparelli S, Mormile M, Sanduzzi Zamparelli A, Guarino A, Parrella R, Bocchino M. Clinical impact of COVID-19 on tuberculosis. Infez Med 2022; 30:495-500. [PMID: 36482953 PMCID: PMC9715002 DOI: 10.53854/liim-3004-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 11/16/2022] [Indexed: 12/12/2022]
Abstract
During COVID-19 pandemic, a lot of diseases suffered from a limited access to health care services, owing to the use of resources, both technical and financial, mainly directed towards such a dramatic outbreak. Among these, tuberculosis (TB) has been one of the most penalized, with a huge delay both in diagnosis and in start of treatment, with a consequential dramatic increase in morbidity and mortality. COVID-19 and tuberculosis share similar common pathogenetic pathways, and both diseases affect primarily the lungs. About the impact of TB on COVID-19 severity and mortality, data are unclear and literature reports are often conflicting. Certainly, considering the management of coinfected patients, there are pharmacokinetic interactions between several drugs used for the therapy of SARS-CoV-2 infection and the treatment of TB.
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Affiliation(s)
| | - Mauro Mormile
- Department of Clinical Medicine and Surgery, Section of Respiratory Diseases, University Federico II, Azienda Ospedaliera dei Colli-Monaldi Hospital, Naples,
Italy
| | - Alessandro Sanduzzi Zamparelli
- Department of Clinical Medicine and Surgery, Section of Respiratory Diseases, University Federico II, Azienda Ospedaliera dei Colli-Monaldi Hospital, Naples,
Italy
| | - Amedeo Guarino
- Department of Public Health, University of Naples Federico II, Naples
Italy
| | - Roberto Parrella
- COVID Unit D, Department of infectious Disease, Cotugno Hospital, A.O.R.N. dei Colli, Naples
Italy
| | - Marialuisa Bocchino
- Department of Clinical Medicine and Surgery, Section of Respiratory Diseases, University Federico II, Azienda Ospedaliera dei Colli-Monaldi Hospital, Naples,
Italy
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15
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Rizzo M, Tammaro G, Guarino A, Basso M, Cozzolino A, Mariconda M. Quality of Life in osteoporotic patients. Orthop Rev (Pavia) 2022; 14:38562. [DOI: 10.52965/001c.38562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background Osteoporosis is responsible for fragility fractures, which are associated with impaired quality of life (QoL) and disability. Objective The aim of the study was to evaluate the QoL in patients affected by osteoporosis and possible determinants. Methods One-hundred thirty-four subjects followed at the osteoprosis outpatient clinic at our institution completed the QUALEFFO-41 questionnaire for quality of life. All subjects had undergone bone densitometry measurement and the FRAX index, summarizing the risk of fragility fracture, was calculated for each of them. The QoL in these subjects and its possible determinants were investigated with univariate and multiple linear regression analysis. Results Subjects with osteoporosis had lower scores in the domains of physical and social function of the QUALEFFO questionnaire in comparison with subjects with normal bome mineral density. Main factors associated with impairment in QoL were high FRAX score and body mass index (BMI). Conclusion Physical and social function is reduced in osteoporotic subjects. High BMI and an increased risk of fragility fracture were main determinants of impairment in the QoL in this study.
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Affiliation(s)
- Maria Rizzo
- Department of Public Health – Section of Orthopaedic Surgery – “Federico II” University - Naples (Italy)
| | - Gisella Tammaro
- Department of Public Health – Section of Orthopaedic Surgery – “Federico II” University - Naples (Italy)
| | - Amedeo Guarino
- Department of Public Health – Section of Orthopaedic Surgery – “Federico II” University - Naples (Italy)
| | - Morena Basso
- Department of Public Health – Section of Orthopaedic Surgery – “Federico II” University - Naples (Italy)
| | - Andrea Cozzolino
- Department of Public Health – Section of Orthopaedic Surgery – “Federico II” University - Naples (Italy)
| | - Massimo Mariconda
- Department of Public Health – Section of Orthopaedic Surgery – “Federico II” University - Naples (Italy)
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16
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Vecchio AL, Nunziata F, Bruzzese D, Conelli ML, Guarino A. Rotavirus immunisation status affects the efficacy of Lacticaseibacillus rhamnosus GG for the treatment of children with acute diarrhoea: a meta-analysis. Benef Microbes 2022; 13:283-294. [PMID: 36004717 DOI: 10.3920/bm2022.0024] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The efficacy of Lacticaseibacillus rhamonosus GG (LGG) for the treatment of children with acute gastroenteritis has been debated based on most recent evidence. Previous evidence demonstrated that LGG mainly benefits children with Rotavirus infection compared to other aetiologies. However, Rotavirus immunisation (RVI) has been implemented worldwide since 2006. We aimed to investigate whether the efficacy of LGG in children with gastroenteritis vary according to RVI status. The MEDLINE, Embase and Cochrane library databases were searched for relevant randomised controlled trials (RCT) up to April 2022. The duration of diarrhoea and episodes lasting >48 h were considered as primary outcomes. The date of vaccine introduction and RVI coverage were reviewed for all countries where trials were conducted. Among the 15 RCTs included in the analysis (n=3,465), only 5 showed a low risk of bias. In RCT conducted before the introduction of RVI (n=2,932), LGG was effective in reducing the duration of diarrhoea compared with placebo or standard care (Median -23.80 h, 95% confidence interval (CI) -36.59 to -11.02]). Only 2 RCTs (n=1,072) reported data of populations partially immunised against Rotavirus with an overall coverage of 44 and 67%, respectively. In this population, LGG showed no efficacy in reducing the duration of diarrhoea (Median -5.34, 95%CI -12.9 to 2.22). Similarly, LGG reduced the risk of diarrhoea lasting >48 h in children not immunised against Rotavirus (RR 0.73, 95%CI 0.54-0.99), but not in population partially immunised (RR 0.98, 95%CI 0.87 to 1.11). The implementation of RVI might affect the efficacy of LGG modifying local epidemiology and susceptibility of the target population to selected probiotics.
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Affiliation(s)
- A Lo Vecchio
- Department of Translational Medical Sciences - Section of Pediatrics, University of Naples Federico II, Via Pansini 5, 80131 Naples, Italy
| | - F Nunziata
- Department of Translational Medical Sciences - Section of Pediatrics, University of Naples Federico II, Via Pansini 5, 80131 Naples, Italy
| | - D Bruzzese
- Department of Public Health, University of Naples Federico II, Via Pansini 5, 80131 Naples, Italy
| | - M L Conelli
- Department of Translational Medical Sciences - Section of Pediatrics, University of Naples Federico II, Via Pansini 5, 80131 Naples, Italy
| | - A Guarino
- Department of Translational Medical Sciences - Section of Pediatrics, University of Naples Federico II, Via Pansini 5, 80131 Naples, Italy
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Festa E, Ascione T, Bernasconi A, Di Gennaro D, Basso MA, Guarino A, Balato G. Diagnostic Performance of Neutrophil to Lymphocyte Ratio, Monocyte to Lymphocyte Ratio, Platelet to Lymphocyte Ratio, and Platelet to Mean Platelet Volume Ratio in Periprosthetic Hip and Knee Infections: A Systematic Review and Meta-Analysis. Diagnostics (Basel) 2022; 12:diagnostics12092033. [PMID: 36140435 PMCID: PMC9497749 DOI: 10.3390/diagnostics12092033] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 08/19/2022] [Accepted: 08/19/2022] [Indexed: 12/20/2022] Open
Abstract
The current literature on the diagnosis of periprosthetic joint infection provides controversial evidence on the diagnostic accuracy of MLR, NLR, PVR, and PLR. Therefore, this critical literature search and meta-analysis was aimed to summarize the diagnostic accuracy of these biomarkers for the diagnosis of hip and knee prosthetic infection. According to the PRISMA flowchart, we searched MEDLINE, Scopus, and Web of Science, for studies on these ratios for diagnosing PJI. Sensitivity, specificity, positive and negative likelihood ratio, diagnostic odds ratio, and AUC were analyzed. We included 11 articles in our meta-analysis, including 7537 patients who underwent total hip and knee arthroplasties; among these, 1974 (26%) patients reported a joint infection. The pooled sensitivity and specificity were 0.72 and 0.74, respectively, for NLR, 0.72 and 0.77 for PVR, and 0.77 and 0.75 for PLR. The sensitivity of MLR ranges from 0.54 to 0.81, while the specificity ranges from 0.78 to 0.81. Regarding the evaluation of AUCs, the best diagnostic performance was achieved by MLR (AUC = 0.77) followed by PLR (AUC = 0.75), NLR (AUC = 0.73), and PVR (AUC = 0.70). This meta-analysis demonstrates a fair diagnostic accuracy of these ratios, thus not being useful as a screening tool.
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Affiliation(s)
- Enrico Festa
- Orthopedic Unit, Department of Public Health, Federico II University Naples, 80131 Naples, Italy
- Correspondence:
| | - Tiziana Ascione
- Service of Infectious Disease, Department of Medicine, Cardarelli Hospital Naples, 80131 Naples, Italy
| | - Alessio Bernasconi
- Orthopedic Unit, Department of Public Health, Federico II University Naples, 80131 Naples, Italy
| | - Donato Di Gennaro
- Orthopedic Unit, Department of Public Health, Federico II University Naples, 80131 Naples, Italy
| | - Morena Anna Basso
- Orthopedic Unit, Department of Public Health, Federico II University Naples, 80131 Naples, Italy
| | - Amedeo Guarino
- Orthopedic Unit, Department of Public Health, Federico II University Naples, 80131 Naples, Italy
| | - Giovanni Balato
- Orthopedic Unit, Department of Public Health, Federico II University Naples, 80131 Naples, Italy
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18
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Fabiani C, Guarino A, Meneghini C, Licata E, Paciotti G, Miriello D, Schiavi M, Spina V, Rago R. P-484 Oocytes quality assessment in breast cancer: implications for fertility preservation. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Study question
Does the breast cancer (BC) influence the oocyte quality and ovarian response to controlled ovarian hyperstimulation (COH) for fertility preservation (FP) in female oncology patients?
Summary answer
The diagnosis of breast cancer does not seem to be associated with an impairment of ovarian reserve, but with a worsening of oocyte quality.
What is known already
Fertility preservation in female oncology patients should be integrated as part of management of cancer patient to improve their quality of life. Every day in Italy about 30 new cases of cancer are diagnosed in patients with age under 40 years and BC is the most common malignancy in women undergoing fertility preservation. Currently mature oocyte cryopreservation is a standard technique for fertility. The studies on the outcome of ovarian response after ovarian stimulation in specific cancer patients are limited. Only few reports have suggested a deleterious impact of the oncological disease on quality of follicular growth and ovarian function.
Study design, size, duration
This is a retrospective single-center case-control study carried out in the IVF (in vitro fertilization) Unit at the Sandro Pertini Hospital in Rome between 2016 and 2021. The aim of this study is to investigate the effect of BC on number, above all on quality of oocyte and on dysmorphic oocyte ratio, in oncology patients compared to women age- and date-matched controls undergoing COH for IVF for male or tubal factor infertility.
Participants/materials, setting, methods
A total of 294 women were enrolled in the study: 105 women affected by breast cancer in the case group and 189 healthy women in the control group. Boths groups were comparable in terms of age, body mass index (BMI) and antimulleran hormone (AMH) value, E2 level at triggering day, total FSH cumulative dose, stage, histotype, BRCA status and hormone receptors. The primary outcome was number and quality of retrievd oocyte from ovarian pick-up (OPU).
Main results and the role of chance
There were no significant differences in terms of basal fertility indices between the 2 groups: median AMH levels were 2.3 ng/mL in BC patients and 2.8 ng/mL in control group (p = 0.103). The median length of stimulation was 11 days in both groups. The median of total immature oocytes (oocytes MI + germinal vesicle) was 2 in cancer patients and 0 in control group (p < 0.0001). Finally, the median of total dysmorphic oocytes were 1 in cancer group vs 0 (p < 0.0001). The multivariable analysis identified the cancer as risk factors of presence of dysmorphic oocytes (OR (95%CI):3.92 (1.84-8.35). Moreover either in the case and control group age, BMI, AMH, duration of stimulation, E2 level at triggering day, total FSH cumulative dose and, only for BC patients, stage, histotype, BRCA status and hormone receptors were not statistical significantly associated with the presence of dysmophic oocytes. Finally, our data confirmed that the cancer is the only risk factors not only for the presence of dysmorphic oocytes, but also respect to the number of dysmorphic oocytes and to the percentage of dysmorphic oocytes respect to the total number of retrieved oocytes for patient. Two patients have had a spontaneous pregnancy.
Limitations, reasons for caution
The limitations concern the paucity of specific cancer group especially BRCA mutated BC patients and the different triggers for induction of final maturation. We still have not a follow up data to evaluate the competence of vitrified MII oocytes for oncology patients and we cannot report information on spontaneous births.
Wider implications of the findings
The BC diagnosis is a four times greater risk factor in retrieving dysmorphic oocytes, but the stage of BC does not influence the number of retrieved dysmorphic oocytes. Further studies are necessary to evaluate the etiopathogenetic mechanisms underlying oocyte abnormalities in specific group of female oncology patients.
Trial registration number
0104898/2020
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Affiliation(s)
- C Fabiani
- Sandro Pertini Hospital, Phisiopathology of Reproduction and Androlgy Unit , Rome, Italy
| | - A Guarino
- Sandro Pertini Hospital, Phisiopathology of Reproduction and Andrology Unit , Rome, Italy
| | - C Meneghini
- Sandro Pertini Hospital, Phisiopathology of Reproduction and Androlgy Unit , Rome, Italy
| | - E Licata
- Sandro Pertini Hospital, Phisiopathology of Reproduction and Androlgy Unit , Rome, Italy
| | - G Paciotti
- Sandro Pertini Hospital, Phisiopathology of Reproduction and Androlgy Unit , Rome, Italy
| | - D Miriello
- Sandro Pertini Hospital, Phisiopathology of Reproduction and Androlgy Unit , Rome, Italy
| | - M Schiavi
- Sandro Pertini Hospital, Obstetrics and Gynecology Unit , Rome, Italy
| | - V Spina
- Asl Rieti, Maternal and Pediatric Health Care Unit , Rieti, Italy
| | - R Rago
- Sandro Pertini Hospital, Phisiopathology of Reproduction and Androlgy Unit , Rome, Italy
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19
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Philippe R, Volani C, Medici A, Texler B, Pagliaro A, Stadiotti I, Meraviglia V, De Bortoli M, Guarino A, Blumer M, Pompilio G, Pramstaller PP, Sommariva E, Troppmair J, Rossini A. Evidence of mitochondrial alterations in primary cardiac stromal cells from arrhythmogenic cardiomyopathy hearts. Cardiovasc Res 2022. [DOI: 10.1093/cvr/cvac066.136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): This research was funded by the Department of Innovation, Research and University of the Autonomous Province of Bolzano-South Tyrol (Italy), and by the Joint Project Südtirol- FWF (Italy-Austria) for A.R., J.T., A.M., R.P..
Background
Arrhythmogenic cardiomyopathy (ACM) is a genetic disease associated with sudden cardiac death and fibro-fatty replacement of myocardium. Recently, it has been demonstrated that oxidized lipid contributes to cardiac adipogenesis and that ACM hearts are characterized by an increase in oxidative stress.
Purpose
As mitochondria are an important source of reactive oxygen species (ROS) within mammalian cells, the present work aims to evaluate if increased oxidative stress observed in ACM hearts is associated with altered mitochondrial function.
Methods
The oxidative stress marker 4HNE was investigated together with the cardiomyocyte marker cardiac Troponin T on paraffin embedded human ventricular samples and analyzed by confocal microscopy.
Human primary cardiac stromal cells (CStCs), obtained from either right ventricle biopsies of ACM patients or healthy cadaveric tissue donor (CTR), were used as cellular model as they are known for their contribution to adipogenesis in the ACM pathology. CStCs were cultured either in basal medium or adipogenic medium (ADIPO) in presence or absence of 500 nM of the ROS scavenger MitoTEMPO.
After 7 days of adipogenic differentiation, intracellular lipid droplets accumulation and mitochondrial superoxide levels were measured in CStCs by confocal microscopy using BODIPY 493/503 (0.5 µM) and MitoSOX Red (5 µM) dyes, respectively.
The oxidative phosphorylation (OXPHOS) and fatty acid oxidation (FAO) were also evaluated in CStCs by high resolution respirometry.
Results
4HNE staining was increased in heart tissues from ACM patients compared to CTRs and particularly evident in non-cardiomyocyte cells. In agreement, a higher MitoSOX fluorescence intensity was found in ACM-CStCs compared to CTR-CStCs in ADIPO medium, confirming higher ROS presence in patient cells. The treatment with MitoTEMPO was efficient in reducing ROS abundance, strongly suggesting mitochondrial origin. Lipid accumulation in ACM-CStCs was also prevented by MitoTEMPO treatment.
Preliminary evidence further indicates that mitochondrial respiratory capacity is increased in ACM-CStCs versus CTR-CStCs exposed to adipogenic medium for 7 days. However, transmission electron microscopy analysis and Western blot analysis of Mfn1/2, Opa1, Fis1 and Drp1 did not show an evident alteration neither in mitochondria ultrastructure nor in the expression of proteins regulating mitochondrial dynamics.
Conclusions
Our data support an alteration of mitochondrial activity in CStCs from ACM patients, apparently not linked to a modified network or morphology of mitochondria but associated with a higher ROS production.
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Affiliation(s)
- R Philippe
- Eurac Research, Institute for Biomedicine (Affiliated Institute of the University of Lübeck, Germany) , Bolzano , Italy
| | - C Volani
- Eurac Research, Institute for Biomedicine (Affiliated Institute of the University of Lübeck, Germany) , Bolzano , Italy
| | - A Medici
- Medical University of Innsbruck, Daniel Swarovski Research Laboratory, Department of Viscercal, Transplant and Thoracic surgery , Innsbruck , Austria
| | - B Texler
- Medical University of Innsbruck, Daniel Swarovski Research Laboratory, Department of Viscercal, Transplant and Thoracic surgery , Innsbruck , Austria
| | - A Pagliaro
- Eurac Research, Institute for Biomedicine (Affiliated Institute of the University of Lübeck, Germany) , Bolzano , Italy
| | - I Stadiotti
- IRCCS Monzino Cardiology Center, Vascular Biology and Regenerative Medicine Unit , Milan , Italy
| | - V Meraviglia
- Eurac Research, Institute for Biomedicine (Affiliated Institute of the University of Lübeck, Germany) , Bolzano , Italy
| | - M De Bortoli
- Eurac Research, Institute for Biomedicine (Affiliated Institute of the University of Lübeck, Germany) , Bolzano , Italy
| | - A Guarino
- IRCCS Monzino Cardiology Center, Cardiovascular Tissue Bank , Milan , Italy
| | - M Blumer
- Medical University of Innsbruck, Department of Anatomy, Histology and Embryology, Division of Clinical and Functional Anatomy , Innsbruck , Austria
| | - G Pompilio
- IRCCS Monzino Cardiology Center, Vascular Biology and Regenerative Medicine Unit , Milan , Italy
| | - PP Pramstaller
- Eurac Research, Institute for Biomedicine (Affiliated Institute of the University of Lübeck, Germany) , Bolzano , Italy
| | - E Sommariva
- IRCCS Monzino Cardiology Center, Vascular Biology and Regenerative Medicine Unit , Milan , Italy
| | - J Troppmair
- Medical University of Innsbruck, Daniel Swarovski Research Laboratory, Department of Viscercal, Transplant and Thoracic surgery , Innsbruck , Austria
| | - A Rossini
- Eurac Research, Institute for Biomedicine (Affiliated Institute of the University of Lübeck, Germany) , Bolzano , Italy
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Stadiotti I, Santoro R, Scopece A, Pirola S, Guarino A, Ascione F, Li Q, Delia D, Foiani M, Pompilio G, Sommariva E. DNA-damage response as a novel pathogenic mechanism of heart failure with preserved ejection fraction. Cardiovasc Res 2022. [DOI: 10.1093/cvr/cvac066.106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Italian Ministry of Health
Background
Heart failure with preserved ejection fraction (HFpEF) is a heterogeneous syndrome characterized by impaired left ventricular (LV) diastolic function, with normal LV ejection fraction. The most common cause is aortic valve stenosis, which provokes sustained pressure overload (PO) (1). HFpEF cardiac remodeling comprises cardiomyocyte (CM) hypertrophy and fibrotic matrix deposition (2). A link between HFpEF pathogenesis and DNA damage response (DDR) activation emerged from in vivo studies (3). DNA damage activates DDR kinases, producing the phosphorylation of H2AX histone and checkpoint proteins, CHK1 and CHK2, to orchestrate cell recovery. DDR activation contributes to mouse CM hypertrophy and inflammation, promoting cardiac remodeling and HF (4)(5). No studies of this molecular mechanism have been performed on HFpEF patient samples yet. Moreover, known the pivotal role of the stromal compartment in the myocardial response to PO (6)(7), the effects of DDR activation on cardiac mesenchymal stromal cells (C-MSC) are still to be investigated.
Purpose
Our aim is to address the aforementioned gaps, unraveling the effects of C-MSC DDR persistent activation on C-MSC phenotypes.
Methods
We collected LV septum samples from patients with HFpEF undergoing aortic valve surgery (n=7) and healthy controls (HC; n=7), both for tissue analyses and C-MSC isolation. PO-induced mechanical stimuli has been simulated in vitro by cyclic unidirectional stretch.
Results
Histological analyses of HFpEF tissues showed enlarged nuclei and hypertrophic cardiac fibers, increased collagen deposition, higher apoptosis and oxidative stress than HC tissues. HFpEF samples revealed DNA damage (% γH2AX positive cells p=0.047), in both CM and C-MSC. γH2AX, pCHK1, pCHK2 protein expression was higher in HFpEF total tissue (γH2AX/GAPDH p= 0.033; pCHK1/GAPDH p= 0.018; pCHK2/GAPDH p= 0.049). Primary human C-MSC isolated from HFpEF and HC cardiac tissues confirmed the increased γH2AX (γH2AX/GAPDH p=0.0030) and phosphorylated checkpoint protein expression (pCHK1/GAPDH p= 0.045; pCHK2/GAPDH p= 0.039), suggesting C-MSC involvement in DDR-driven remodeling. HFpEF C-MSC express also more pro-fibrotic and pro-inflammatory factors than HC cells.
In response to in vitro mechanical stimulation, HC C-MSC increased DNA damage (% γH2AX positive cells non-stretched vs. stretched cells p=0.022) and phosphorylated checkpoint proteins, suggesting PO-guided activation of DDR. Stretched C-MSC secreted more pro-inflammatory and pro-fibrotic molecules compared to static control.
Conclusion
HFpEF sustained PO induces DDR persistent activation not only in CM but also in C-MSC. On C-MSC, DDR impairments are linked to inflammation and fibrosis, with direct effects on C-MSC protein expression and secretome. The factors released by C-MSC could further impair CM function. Future studies will unravel the potential anti-fibrotic and anti-hypertrophic effects of DDR inhibitors in HFpEF context.
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Affiliation(s)
- I Stadiotti
- IRCCS Monzino Cardiology Center , Milan , Italy
| | - R Santoro
- IRCCS Monzino Cardiology Center , Milan , Italy
| | - A Scopece
- IRCCS Monzino Cardiology Center , Milan , Italy
| | - S Pirola
- IRCCS Monzino Cardiology Center , Milan , Italy
| | - A Guarino
- IRCCS Monzino Cardiology Center , Milan , Italy
| | - F Ascione
- IFOM, FIRC Institute of Molecular Oncology , Milan , Italy
| | - Q Li
- IFOM, FIRC Institute of Molecular Oncology , Milan , Italy
| | - D Delia
- IFOM, FIRC Institute of Molecular Oncology , Milan , Italy
| | - M Foiani
- IFOM, FIRC Institute of Molecular Oncology , Milan , Italy
| | - G Pompilio
- IRCCS Monzino Cardiology Center , Milan , Italy
| | - E Sommariva
- IRCCS Monzino Cardiology Center , Milan , Italy
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21
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Guarino A, Farinelli L, Iacono V, Screpis D, Piovan G, Rizzo M, Mariconda M, Zorzi C. Lateral extra-articular tenodesis and anterior cruciate ligament reconstruction in young patients: clinical results and return to sport. Orthop Rev (Pavia) 2022; 14:33696. [PMID: 35774923 PMCID: PMC9239354 DOI: 10.52965/001c.33696] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 12/23/2021] [Indexed: 03/24/2024] Open
Abstract
Lateral extra-articular tenodesis (L.E.T.) have been proposed to reduce the tibia's anterior translation and internal rotation in concomitant to Anterior cruciate ligament (A.C.L.) reconstruction. Recent studies show that the addition of L.E.T. to A.C.L. reconstruction results in a statistically significant reduction in graft failure. The purpose of the present study was to evaluate the clinical outcomes, complications, and rate of return to preinjury sports level in pediatric patients who underwent combined A.C.L. reconstruction with L.E.T. at a minimum 2-year follow-up. The authors retrospectively evaluated 42 pediatric patients at high risk of graft failure who experienced ACLR connected to L.E.T. IKDC and Tegner-Lysholm Knee Scores Scale were used to assess clinical outcomes, and the Tegner Activity Scale to evaluate the return to sport. No graft failure or subsequent surgery related to A.C.L. reconstruction occurred. Furthermore, 88% of patients returned to the sport. Satisfactory clinical results were obtained on a short and medium-term follow-up. These findings help to consider this procedure for active adolescents at a high risk of graft failure to enhance A.C.L. reconstruction.
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Affiliation(s)
- Amedeo Guarino
- Section of Orthopaedics. Department of Public Health, Federico II University, Naples (NA), Italy
| | - Luca Farinelli
- Clinical Orthopaedics Departement of Clinical and Molecular Sciences, Università Politecnica delle Marche, Ancona(AN), Italy
| | - Venanzio Iacono
- Department of Orthopaedic Surgery, IRCCS Sacro Cuore - Don Calabria in Negrar (VE), Italy
| | - Daniele Screpis
- Department of Orthopaedic Surgery, IRCCS Sacro Cuore - Don Calabria in Negrar (VE), Italy
| | - Gianluca Piovan
- Department of Orthopaedic Surgery, IRCCS Sacro Cuore - Don Calabria in Negrar (VE), Italy
| | - Maria Rizzo
- Section of Orthopaedics. Department of Public Health, Federico II University, Naples (NA), Italy
| | - Massimo Mariconda
- Section of Orthopaedics. Department of Public Health, Federico II University, Naples (NA), Italy
| | - Claudio Zorzi
- Department of Orthopaedic Surgery, IRCCS Sacro Cuore - Don Calabria in Negrar (VE), Italy
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22
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Padovani L, Iacono V, Auregli L, Guarino A, Natali S, Zorzi C, Mariconda M. Traumatic biceps femoris tendon subluxation in a young football player. Orthop Rev (Pavia) 2022; 14:34184. [DOI: 10.52965/001c.34184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 12/28/2021] [Indexed: 11/06/2022] Open
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23
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Pagano F, Amato C, De Marco G, Micillo M, Cecere G, Poeta M, Guarino A, Lo Vecchio A. Reduction in broad-spectrum antimicrobial prescriptions by primary care pediatricians following a multifaceted antimicrobial stewardship program. Front Pediatr 2022; 10:1070325. [PMID: 36683814 PMCID: PMC9853423 DOI: 10.3389/fped.2022.1070325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 12/08/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Since 2016, following the Italian "National Plan to Contrast Antimicrobial Resistance", Campania Region has implemented an antimicrobial stewardship program, including the obligation to associate an appropriate International Classification of Diseases-9 code to each antibiotic prescription, the publication of schemes for empirical antibiotic therapy and educational interventions. METHODS To evaluate the impact of these interventions on the prescribing habits of family pediatricians, we conducted a retrospective cohort study (January 2016-December 2020), including all patients registered in an associate practice of Primary Care Pediatricians. We collected data on antibiotic prescriptions through a specific study management software; our primary outcomes were the annual prescription rates, calculated for both the number of patients in follow-up and the number of medical consultations, and the annual prescription rates for selected antibiotic classes and molecules. To investigate the hypothesis that chronic conditions would be associated with an increased rate of prescription, we also tested the association between underlying conditions and the number of antibiotics received. RESULTS During the study period, 2,599 children received 11,364 antibiotic prescriptions (mean 4.37, SD 4.28). From 2016 to 2020 we observed a substantial reduction in both the annual prescription rate per 100 patients (9.33 to 3.39; R 2 = 0.927, p = 0.009), and the annual prescription rate per 100 medical consultations (25.49 to 15.98; R 2 = 0.996, p < 0.01). The prescription rates of Amoxicillin-Clavulanate (50.25 to 14.21; R 2 = 0.983, p = 0.001) and third generation Cephalosporins (28.43 to 5.43; R 2 = 0.995, p < 0.01) significantly decreased; we didn't find significant modifications in the prescription rates of Amoxicillin and Quinolones; finally, we observed a trend toward reduction in the prescription of Macrolides. No statistical association was found between antibiotics prescribing frequency and history of chronic diseases. DISCUSSION Following the implementation of the regional interventions on antimicrobial stewardship, we observed a substantial reduction in the overall antibiotic prescription per patients and per medical consultations, with a statistically significant reduction in the use of broad-spectrum molecules. Considering the results of our analysis, new guidance and training interventions addressed to specialists in the primary care sector should be implemented to further limit antibiotic resistance.
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Affiliation(s)
- F Pagano
- Department of Translational Medical Sciences, Section of Pediatrics, University of Naples Federico II, Naples, Italy
| | - C Amato
- Department of Translational Medical Sciences, Section of Pediatrics, University of Naples Federico II, Naples, Italy
| | - G De Marco
- U.O. Materno Infantile, ASL Napoli 1 Centro, Distretto Sanitario 28, Naples, Italy
| | - M Micillo
- U.O. Materno Infantile, ASL Napoli 1 Centro, Distretto Sanitario 28, Naples, Italy
| | - G Cecere
- U.O. Materno Infantile, ASL Napoli 1 Centro, Distretto Sanitario 28, Naples, Italy
| | - M Poeta
- Department of Translational Medical Sciences, Section of Pediatrics, University of Naples Federico II, Naples, Italy
| | - A Guarino
- Department of Translational Medical Sciences, Section of Pediatrics, University of Naples Federico II, Naples, Italy
| | - A Lo Vecchio
- Department of Translational Medical Sciences, Section of Pediatrics, University of Naples Federico II, Naples, Italy
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24
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Banfi C, Baetta R, Barbieri SS, Brioschi M, Guarino A, Ghilardi S, Sandrini L, Eligini S, Polvani G, Bergman O, Eriksson P, Tremoli E. Prenylcysteine oxidase 1, an emerging player in atherosclerosis. Commun Biol 2021; 4:1109. [PMID: 34548610 PMCID: PMC8455616 DOI: 10.1038/s42003-021-02630-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 09/02/2021] [Indexed: 02/08/2023] Open
Abstract
The research into the pathophysiology of atherosclerosis has considerably increased our understanding of the disease complexity, but still many questions remain unanswered, both mechanistically and pharmacologically. Here, we provided evidence that the pro-oxidant enzyme Prenylcysteine Oxidase 1 (PCYOX1), in the human atherosclerotic lesions, is both synthesized locally and transported within the subintimal space by proatherogenic lipoproteins accumulating in the arterial wall during atherogenesis. Further, Pcyox1 deficiency in Apoe-/- mice retards atheroprogression, is associated with decreased features of lesion vulnerability and lower levels of lipid peroxidation, reduces plasma lipid levels and inflammation. PCYOX1 silencing in vitro affects the cellular proteome by influencing multiple functions related to inflammation, oxidative stress, and platelet adhesion. Collectively, these findings identify the pro-oxidant enzyme PCYOX1 as an emerging player in atherogenesis and, therefore, understanding the biology and mechanisms of all functions of this unique enzyme is likely to provide additional therapeutic opportunities in addressing atherosclerosis.
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Affiliation(s)
- C. Banfi
- grid.418230.c0000 0004 1760 1750Centro Cardiologico Monzino IRCCS, Milano, Italy
| | - R. Baetta
- grid.418230.c0000 0004 1760 1750Centro Cardiologico Monzino IRCCS, Milano, Italy
| | - S. S. Barbieri
- grid.418230.c0000 0004 1760 1750Centro Cardiologico Monzino IRCCS, Milano, Italy
| | - M. Brioschi
- grid.418230.c0000 0004 1760 1750Centro Cardiologico Monzino IRCCS, Milano, Italy
| | - A. Guarino
- grid.418230.c0000 0004 1760 1750Cardiovascular Tissue Bank of Milan, Centro Cardiologico Monzino IRCCS, Milano, Italy
| | - S. Ghilardi
- grid.418230.c0000 0004 1760 1750Centro Cardiologico Monzino IRCCS, Milano, Italy
| | - L. Sandrini
- grid.418230.c0000 0004 1760 1750Centro Cardiologico Monzino IRCCS, Milano, Italy
| | - S. Eligini
- grid.418230.c0000 0004 1760 1750Centro Cardiologico Monzino IRCCS, Milano, Italy
| | - G. Polvani
- grid.418230.c0000 0004 1760 1750Cardiovascular Tissue Bank of Milan, Centro Cardiologico Monzino IRCCS, Milano, Italy ,grid.4708.b0000 0004 1757 2822Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milano, Italy ,grid.418230.c0000 0004 1760 1750Department of Cardiovascular Disease, Development and Innovation Cardiac Surgery Unit, Centro Cardiologico Monzino IRCCS, Milano, Italy
| | - O. Bergman
- grid.4714.60000 0004 1937 0626Department of Medicine Solna, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
| | - P. Eriksson
- grid.4714.60000 0004 1937 0626Department of Medicine Solna, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
| | - E. Tremoli
- grid.418230.c0000 0004 1760 1750Centro Cardiologico Monzino IRCCS, Milano, Italy
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25
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Candia FD, Moracas C, Chiatto F, Mango C, Bruzzese E, Guarino A, Spagnuolo M. KOCURIA SPECIES: EMERGING PATHOGENS IN CHILDREN WITH CENTRAL VENOUS CATHETER, A CASE REPORT AND REVIEW OF LITERATURE. Nutrition 2021. [DOI: 10.1016/j.nut.2021.111328] [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: 11/27/2022]
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26
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Basso MA, Rizzo M, Famiglietti G, Guarino A, de Giovanni R, Smeraglia F. Thumb basal joint interpositional arthroplasty: a systematic review. J BIOL REG HOMEOS AG 2020; 34:39-44. IORS Special Issue on Orthopedics. [PMID: 33739003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The aim of this systematic review was to analyze the failure rates among different trapeziometacarpal interposition implants used to treat thumb basal joint osteoarthritis. We searched Medline (PubMed), Web of Science and Scopus databases, to identify articles reporting on thumb interpositional arthroplasty, in English literature. We excluded studies with less than 35 cases and with a follow-up shorter than 24 months. Twenty-one studies were included. We assessed the quality of the studies using the Coleman Methodological Score. The mean quality of the studies was moderate. The total number of procedures included in this review was 1205. The failure rate for interposition implants was 11%. The main longterm complication was dislocation, which is also the major reason for revision.
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Affiliation(s)
- M A Basso
- Department of Public Health, Section of Orthopaedic Surgery, "Federico II" University, Naples, Italy
| | - M Rizzo
- Department of Public Health, Section of Orthopaedic Surgery, "Federico II" University, Naples, Italy
| | - G Famiglietti
- Department of Public Health, Section of Orthopaedic Surgery, "Federico II" University, Naples, Italy
| | - A Guarino
- Department of Public Health, Section of Orthopaedic Surgery, "Federico II" University, Naples, Italy
| | - R de Giovanni
- Department of Public Health, Section of Orthopaedic Surgery, "Federico II" University, Naples, Italy
| | - F Smeraglia
- Department of Public Health, Section of Orthopaedic Surgery, "Federico II" University, Naples, Italy
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27
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Zhang J, Cameron D, Quak SH, Kadim M, Mohan N, Ryoo E, Sandhu B, Yamashiro Y, Guarino A, Hoekstra H. Rates and determinants of antibiotics and probiotics prescription to children in Asia-Pacific countries. Benef Microbes 2020; 11:329-338. [PMID: 32506933 DOI: 10.3920/bm2019.0203] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Antibiotic therapy may have important side effects. Guidelines recommend the administration of specific probiotics to reduce the risk of antibiotic-associated diarrhoea (AAD). The rates and determinants of antibiotics and co-prescription of probiotics in children remain poorly known in Asia-Pacific countries, which are very heterogenous in terms of economic development, health care organization and health policies. A survey among general practitioners (GPs) and paediatricians was performed in seven countries of the Asia-Pacific area (Australia, Japan, Indonesia, India, China, Singapore, and South Korea). Physicians completed an online questionnaire that explored their current habits and the determinants for prescribing antibiotics and probiotics. For the 731 physicians who completed the questionnaire (390 paediatricians and 341 GPs), 37% of all consultations for a child led to the prescription of antibiotics (ranging from 17% in Australia to 47% in India). A large majority of physicians (84%) agreed that antibiotics disrupted gut microbiota and considered probiotics an effective intervention to prevent AAD (68%). However, only 33% co-prescribed probiotics with antibiotics (ranging from 13% in Japan to 60% in South Korea). The main reasons for prescribing probiotics were previous episodes of AAD (61%), presence of diarrhoea (55%), prolonged antibiotic treatment (54%) or amoxicillin-clavulanic acid therapy (54%). Although current local guidelines recommend the use of selected probiotics in children receiving antibiotics in Asia-Pacific area, the rates of antibiotics and probiotics prescription significantly vary among countries and are deeply affected by country-related cultural and organisational issues.
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Affiliation(s)
- J Zhang
- The Children's Hospital, School of Medicine, Zhejiang University, 3333 Binsheng Road, 310052 Hangzhou, Zhejiang, China P.R
| | - D Cameron
- Royal Children's Hospital Melbourne, Department of Gastroenterology, 50 Flemington Road, 3052 Parkville, Australia
| | - S H Quak
- Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, Singapore 117597, Singapore
| | - M Kadim
- Faculty of Medicine, University of Indonesia, Department of Child Health, Jl Salemba Raya Mo 6, 10430 Jakarta, Indonesia
| | - N Mohan
- Center of Child Health, Department of Pediatrics, Sir Ganga Ram Hospital, 110060 New Delhi, India
| | - E Ryoo
- Gachon University, Gil Medical Center, Department of Pediatrics, 21, Namdong-daero 774 beon-gil, Namdong-gu, Incheon, 21565, South Korea
| | - B Sandhu
- Bristol Royal Hospital for Children, Department of Pediatric Gastroenterology, Upper Maudlin St, Bristol BS2 8BJ, United Kingdom
| | - Y Yamashiro
- Juntendo University, Graduate School of Medicine, Probiotics Research Laboratory, 3rd floor, 2-9-8 Hongo, Bunkyo-ku, 113-0033 Tokyo, Japan
| | - A Guarino
- University of Naples, Unit of Pediatric Infectious Diseases, Via Sergio Pansini 5, 80131 Naples, Italy
| | - H Hoekstra
- Hieronymus Bosch Teaching Hospital, Department of Pediatrics, H. Dunantstraat 1, 5223 GZ's-Hertogenbosch, the Netherlands
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28
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Rizzo M, Russo AP, Guarino A, Izzo A, Mariconda M. A comparative study of combined intravenous and topical administration of tranexamic acid with topical tranexamic acid alone for blood loss reduction after primary uncemented total hip arthroplasty. J BIOL REG HOMEOS AG 2020; 34:105-110. ADVANCES IN MUSCULOSKELETAL DISEASES AND INFECTIONS-SOTIMI 2019. [PMID: 32856448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The aim of the present study was to evaluate the efficacy of topical versus combined (intravenous + topical) tranexamic acid (TXA) to reduce perioperative blood loss after uncemented primary total hip arthroplasty (THA). Seventy-five patients were randomized in three comparable experimental groups: 1) topical TXA (3 g in 50 ml of saline solution); 2) intravenous + topical TXA (3 g topical + 2 g in 100 ml of saline solution intravenously); 3) controls. Pre- and post-operative hemoglobin (Hb) levels and hematocrit (Hct) values along with the rate of blood transfusion in the 3 groups were compared. The intravenous + topical TXA group demonstrated higher Hb levels and Hct values at postoperative day one (Hb = p <0.05, Hct = p <0.001), postoperative day three (Hb = p <0.05, Hct = p <0.001), and discharge (Hct = p <0.01) compared to the control group. The intravenous + topical group had a lower transfusion rate compared to the control group (0% vs 20%, p = 0.014). With the numbers available, no difference in postoperative Hb level and transfusion rate emerged between topical TXA and control group.
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Affiliation(s)
- M Rizzo
- Department of Public Health - Section of Orthopaedic Surgery - "Federico II" University - Naples, Via Sergio Pansini 5, 80131 Naples, Italy
| | - A P Russo
- Department of Public Health - Section of Orthopaedic Surgery - "Federico II" University - Naples, Via Sergio Pansini 5, 80131 Naples, Italy
| | - A Guarino
- Department of Public Health - Section of Orthopaedic Surgery - "Federico II" University - Naples, Via Sergio Pansini 5, 80131 Naples, Italy
| | - A Izzo
- Department of Public Health - Section of Orthopaedic Surgery - "Federico II" University - Naples, Via Sergio Pansini 5, 80131 Naples, Italy
| | - M Mariconda
- Department of Public Health - Section of Orthopaedic Surgery - "Federico II" University - Naples, Via Sergio Pansini 5, 80131 Naples, Italy
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Cozza G, Pinto A, Giovanale V, Bianchi P, Guarino A, Marziani R, Frega A, Caserta D. Comparative effectiveness and impact on health-related quality of life of hysterectomy vs. levonorgestrel intra-uterine system for abnormal uterine bleeding. Eur Rev Med Pharmacol Sci 2017; 21:2255-2260. [PMID: 28537655] [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] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To compare hysterectomy and levonorgestrel intra-uterine system (LNG-IUS) for the treatment of abnormal uterine bleeding (AUB) and iron deficiency anemia. PATIENTS AND METHODS Retrospective study evaluating quality of life, sexual function, satisfaction and blood hemoglobin concentration improvement in 60 pre-menopausal women treated with hysterectomy or LNG-IUS. All analysis was performed with statistical software SPSS 21.0 (SPSS Inc., Chicago, IL, USA). RESULTS Despite superior control of bleeding and dysmenorrhea observed after hysterectomy, LNG-IUS showed similar impact on blood hemoglobin levels, quality of life, satisfaction and sexual function resulting more cost-effective. CONCLUSIONS In the absence of contraindications, LNG-IUS should always be the first therapeutic choice for chronic AUB. Surgical treatment must be considered as an "extrema ratio".
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Affiliation(s)
- G Cozza
- Department of Medical and Surgical Science and Translation Medicine, Sant'Andrea Hospital, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy.
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30
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Frega A, Lavini G, Guarino A, Giovanale V, Lukic A, Bianchi P, Cozza G, Marziani R, D'Ambrosio A, French D, Caserta D. Cervical carcinogenesis, bacterial vaginosis, HPV-mRNA test and relapse of CIN2+ after loop electrosurgical excision procedure (LEEP). Eur Rev Med Pharmacol Sci 2017; 21:2504-2511. [PMID: 28617533] [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] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE The aim of the study was to evaluate the relationship between bacterial vaginosis (BV) and relapse of cervical intraepithelial neoplasia grade 2 or more (CIN2+) after Loop electrosurgical excision procedure (LEEP). PATIENTS AND METHODS One hundred four patients who underwent LEEP for CIN2+ were followed up every six months for three years. Fifty-three were negative for BV and fifty-one were positive. Each clinical control included Pap test, colposcopy, Amsel criteria test, HPV-DNA, and HPV-mRNA test. RESULTS Patients' age, presence of BV, positivity to HPV-DNA and HPV-mRNA tests were analyzed. The average age of patients was 42.5 ± 8.92 years (median: 42.5; range from 27 to 58 years). The minimum follow-up was 6 months and maximum 36 months (average: 22.8 ± 4.53; median: 24). The 10% of the patients with HPV-mRNA test negative had relapsed, compared to 45% of patients with HPV-mRNA test positive. Among the 53 patients without BV the 20% had relapsed compared with 23% of 51 patients with diagnosis of BV. CONCLUSIONS There is no evidence for higher percentage of relapse in patients with BV, submitted to excisional procedure for CIN2+ associated to HPV-m-RNA test positivity. There is only a correlation among BV and relapse of CIN2+ lesions after LEEP.
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Affiliation(s)
- A Frega
- Department of Medical and Surgical Science and Translation Medicine, Sant'Andrea Hospital, School of Medicine and Psychology, Sapienza University of Rome, Rome, Italy.
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Buccigrossi V, Russo C, Guarino A, de Freitas MB, Guarino A. Mechanisms of antidiarrhoeal effects by diosmectite in human intestinal cells. Gut Pathog 2017; 9:23. [PMID: 28450899 PMCID: PMC5404323 DOI: 10.1186/s13099-017-0172-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 04/11/2017] [Indexed: 12/16/2022] Open
Abstract
Background Rotavirus (RV) induces diarrhoea through a sequence of enterotoxic and cytotoxic effects. The former are NSP4-dependent, induce calcium-dependent chloride secretion and involve oxidative stress. Diosmectite (DS) is a natural clay that has been recommended as an active therapy for diarrhoea, but the mechanism of its effect is not clear. Electrical parameters may be used to measure the direct enterotoxic and cytotoxic effects in polar epithelial intestinal cells. To investigate the effects of DS on RV-induced enterotoxic and cytotoxic damage. Caco-2 cells were used as a model of RV infection to evaluate chloride secretion, epithelial integrity, oxidative stress and viral infectivity in Ussing chambers. Results Diosmectite reduced the expression of NSP4 and oxidative stress, resulting in a strong inhibition of chloride secretion. Preincubating RV with DS reduced the cytotoxic effect. Finally, the viral load was reduced by DS but not by control clay. This result suggests that DS specifically affects the early events of RV infection protecting the enterocyte, whereas it does not restore already-established cell damage. Conclusion These findings indicate that DS exerts an anti-diarrhoeal effect by inhibiting viral replication and the expression of NSP4. Both ion secretion and cell damage induced by RV are strongly inhibited consequent to the antiviral effect, which explains its clinical efficacy.
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Affiliation(s)
- Vittoria Buccigrossi
- Department of Translational Medical Science, Section of Pediatrics, University of Naples Federico II, via S. Pansini 5, 80131 Naples, Italy
| | - Carla Russo
- Department of Translational Medical Science, Section of Pediatrics, University of Naples Federico II, via S. Pansini 5, 80131 Naples, Italy
| | - Amedeo Guarino
- Department of Translational Medical Science, Section of Pediatrics, University of Naples Federico II, via S. Pansini 5, 80131 Naples, Italy
| | - Maiara Brusco de Freitas
- Department of Nutrition, Federal University of Santa Catarina, Florianópolis, Santa Catarina Brazil
| | - Alfredo Guarino
- Department of Translational Medical Science, Section of Pediatrics, University of Naples Federico II, via S. Pansini 5, 80131 Naples, Italy
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Lopetuso L, Graziani C, Guarino A, Lamborghini A, Masi S, Stanghellini V. Gelatin tannate and tyndallized probiotics: a novel approach for treatment of diarrhea. Eur Rev Med Pharmacol Sci 2017; 21:873-883. [PMID: 28272692] [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] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Intestinal permeability impairment is implicated in many gastrointestinal (GI) diseases. Chronic diarrhea, defined as the presence of diarrhea for more than 3 weeks in adults and 2 weeks in children, requires a different diagnostic and therapeutic work-up than acute diarrhea. Gelatin tannate, by reducing the clinical activity of acute colitis and the proinflammatory effects of lipopolysaccharide (LPS), is emerging as a mucosal barrier protector. MATERIALS AND METHODS New therapeutic strategies focusing on the physiological function of the intestinal barrier, may offer an innovative approach for the clinical improvement of highly debilitating chronic GI diseases. We review the available data on the role of gelatin tannate and tyndallized probiotics in the treatment of diarrhea. RESULTS Gelatin tannate and tyndallized probiotics can be used to re-establish the physiological functions of the gut barrier, as well as for preventing dysbiosis. There is evidence that due to their particular properties, gelatin tannate and tyndallized probiotics are highly effective in the treatment of acute gastroenteritis and may be especially indicated in the management of moderate and prolonged diarrhea. CONCLUSIONS Gelatin tannate and tyndallized probiotics may be effective in the management of chronic diarrhea. Further clinical trials are necessary to further explore their effects in clinical practice.
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Affiliation(s)
- L Lopetuso
- Department of Internal Medicine, Gastroenterology Division, Catholic University of the Sacred Heart, A. Gemelli Foundation, School of Medicine, Rome, Italy.
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Chiappini E, Lo Vecchio A, Garazzino S, Marseglia GL, Bernardi F, Castagnola E, Tomà P, Cirillo D, Russo C, Gabiano C, Ciofi D, Losurdo G, Bocchino M, Tortoli E, Tadolini M, Villani A, Guarino A, Esposito S. Recommendations for the diagnosis of pediatric tuberculosis. Eur J Clin Microbiol Infect Dis 2016; 35:1-18. [PMID: 26476550 DOI: 10.1007/s10096-015-2507-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2015] [Accepted: 10/07/2015] [Indexed: 01/10/2023]
Abstract
Tuberculosis (TB) is still the world's second most frequent cause of death due to infectious diseases after HIV infection, and this has aroused greater interest in identifying and managing exposed subjects, whether they are simply infected or have developed one of the clinical variants of the disease. Unfortunately, not even the latest laboratory techniques are always successful in identifying affected children because they are more likely to have negative cultures and tuberculin skin test results, equivocal chest X-ray findings, and atypical clinical manifestations than adults. Furthermore, they are at greater risk of progressing from infection to active disease, particularly if they are very young. Consequently, pediatricians have to use different diagnostic strategies that specifically address the needs of children. This document describes the recommendations of a group of scientific societies concerning the signs and symptoms suggesting pediatric TB, and the diagnostic approach towards children with suspected disease.
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Lo Vecchio A, Lancella L, Tagliabue C, De Giacomo C, Garazzino S, Mainetti M, Cursi L, Borali E, De Vita MV, Boccuzzi E, Castellazzi L, Esposito S, Guarino A. Clostridium difficile infection in children: epidemiology and risk of recurrence in a low-prevalence country. Eur J Clin Microbiol Infect Dis 2016; 36:177-185. [PMID: 27696233 DOI: 10.1007/s10096-016-2793-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [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: 08/16/2016] [Accepted: 09/16/2016] [Indexed: 02/07/2023]
Abstract
Clostridium difficile infection (CDI) is increasingly found in children worldwide, but limited data are available from children living in southern Europe. A 6-year retrospective study was performed to investigate the epidemiology, clinical features, treatment, and risk of recurrence in Italy. Data of children with community- and hospital-acquired CDI (CA-CDI and HA-CDI, respectively) seen at seven pediatric referral centers in Italy were recorded retrospectively. Annual infection rates/10,000 hospital admissions were calculated. Logistic regression was used to investigate risk factors for recurrence. A total of 177 CDI episodes was reported in 148 children (83 males, median age 55.3 months), with a cumulative infection rate of 2.25/10,000 admissions, with no significant variability over time. The majority of children (60.8 %) had CA-CDI. Children with HA-CDI (39.2 %) had a longer duration of symptoms and hospitalization (p = 0.003) and a more common previous use of antibiotics (p = 0.0001). Metronidazole was used in 70.7 % of cases (87/123) and vancomycin in 29.3 % (36/123), with similar success rates. Recurrence occurred in 16 children (10.8 %), and 3 (2 %) of them presented a further treatment failure. The use of metronidazole was associated with a 5-fold increase in the risk of recurrence [odds ratio (OR) 5.18, 95 % confidence interval (CI) 1.1-23.8, p = 0.03]. Short bowel syndrome was the only underlying condition associated with treatment failure (OR 5.29, 95 % CI 1.17-23.8, p = 0.03). The incidence of pediatric CDI in Italy is low and substantially stable. In this setting, there is a limited risk of recurrence, which mainly concerns children treated with oral metronidazole and those with short bowel syndrome.
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Affiliation(s)
- A Lo Vecchio
- Department of Translational Medical Science, Section of Pediatrics, University of Naples Federico II, Via Sergio Pansini 5, 80131, Naples, Italy.
| | - L Lancella
- Ospedale Pediatrico Bambino Gesù, Piazza Sant'Onofrio 4, Rome, Italy
| | - C Tagliabue
- Università degli Studi di Milano Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Gaetano Pini 3, Milan, Italy
| | - C De Giacomo
- Grande Ospedale Metropolitano Niguarda, Piazza dell'Ospedale Maggiore 3, Milan, Italy
| | - S Garazzino
- Regina Margherita Children's Hospital, University of Turin, Piazza Polonia 94, Turin, Italy
| | - M Mainetti
- Hospital of Ravenna, Via Vincenzo Randi 5, Ravenna, Italy
| | - L Cursi
- Ospedale Pediatrico Bambino Gesù, Piazza Sant'Onofrio 4, Rome, Italy
| | - E Borali
- Grande Ospedale Metropolitano Niguarda, Piazza dell'Ospedale Maggiore 3, Milan, Italy
| | - M V De Vita
- Regina Margherita Children's Hospital, University of Turin, Piazza Polonia 94, Turin, Italy
| | - E Boccuzzi
- Ospedale Pediatrico Bambino Gesù, Piazza Sant'Onofrio 4, Rome, Italy
| | - L Castellazzi
- Università degli Studi di Milano Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Gaetano Pini 3, Milan, Italy
| | - S Esposito
- Università degli Studi di Milano Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Gaetano Pini 3, Milan, Italy
| | - A Guarino
- Department of Translational Medical Science, Section of Pediatrics, University of Naples Federico II, Via Sergio Pansini 5, 80131, Naples, Italy
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Bruzzese E, Fedele MC, Bruzzese D, Viscovo S, Giannattasio A, Mandato C, Siani P, Guarino A. Randomised clinical trial: a Lactobacillus GG and micronutrient-containing mixture is effective in reducing nosocomial infections in children, vs. placebo. Aliment Pharmacol Ther 2016; 44:568-75. [PMID: 27464469 DOI: 10.1111/apt.13740] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 04/06/2016] [Accepted: 07/02/2016] [Indexed: 12/26/2022]
Abstract
BACKGROUND Nosocomial infections are a major public health issue and preventative strategies using probiotics and micronutrients are being evaluated. AIM To investigate the efficacy of a mixture of Lactobacillus GG and micronutrients in preventing nosocomial infections in children. METHODS A randomised, double-blind, placebo-controlled trial was conducted in hospitalised children. Children (6 months to 5 years of age) received Lactobacillus GG (6 × 10(9) CFU/day) together with vitamins B and C and zinc or placebo, for 15 days, starting on the first day of hospitalisation. The incidence of gastrointestinal and respiratory nosocomial infections after discharge was determined by follow-up telephone call at 7 days. After 3 months, another telephone call estimated the incidence of further infections during follow-up. RESULTS Ninety children completed the follow-up. Of 19/90 children with a nosocomial infection (20%), 4/45 children (9%) were in the treatment group and 15/45 (33%) in the placebo group (P = 0.016). Specifically, 2/45 (4%) children in the treatment group vs. 11/45 (24%) children in the placebo group (P = 0.007) presented with diarrhoea. The duration of hospitalisation was significantly shorter in the treatment group (3.9 days ± 1.7 vs. 4.9 ± 1.2; P = 0.003). At the follow-up, a total of 11/45 (24.4%) children in the treatment group had at least one episode of infection compared to 22/45 (48.9%) in the placebo group (P = 0.016). CONCLUSION A mixture containing Lactobacillus GG and micronutrients may reduce the incidence of nosocomial infections, supporting the hypothesis that this may represent a valid strategy to prevent nosocomial infections.
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Affiliation(s)
- E Bruzzese
- Department of Translational Medical Science, Section of Pediatrics, University Federico II, Naples, Italy
| | - M C Fedele
- Department of Translational Medical Science, Section of Pediatrics, University Federico II, Naples, Italy
| | - D Bruzzese
- Department of Public Health, University Federico II, Naples, Italy
| | - S Viscovo
- Department of Translational Medical Science, Section of Pediatrics, University Federico II, Naples, Italy
| | - A Giannattasio
- Department of Translational Medical Science, Section of Pediatrics, University Federico II, Naples, Italy
| | - C Mandato
- Department of Pediatrics, AORN Santobono-Pausilipon, Naples, Italy
| | - P Siani
- Department of Pediatrics, AORN Santobono-Pausilipon, Naples, Italy
| | - A Guarino
- Department of Translational Medical Science, Section of Pediatrics, University Federico II, Naples, Italy
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Frega A, Manzara F, Schimberni M, Guarino A, Catalano A, Bianchi P, Marziani R, Cozza G, Milazzo GN, French D, Caserta D. Human papilloma virus infection and cervical cytomorphological changing among intrauterine contraception users. Eur Rev Med Pharmacol Sci 2016; 20:3528-3534. [PMID: 27649651] [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] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE The increased use of the intrauterine contraception (IUC) in female population and its probable relationship with cervical squamous intraepithelial lesions and cervical cancer make necessary clarify the possible interaction between the device and the pre-neoplastic lesions. PATIENTS AND METHODS Seven hundred and eighty-nine patients users of IUC and 1491 patients ever users of IUC were followed every 6 months for 3 years. Each clinical control included Papanicolau test, colposcopy, HPV-DNA test and HPV-mRNA test. Also, in patients IUC users we analyzed the type of device, years of use and average age. RESULTS Cytological sampling, histological examination, HPV-DNA test and HPV-mRNA test showed that there are not significantly differences between patients with or without IUC. CONCLUSIONS None difference arose regarding persistence and progression between patients IUC users and IUC no users, for this reason, intrauterine contraception does not seem to be a co-causal factor in the possible development of cervical cancer.
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Affiliation(s)
- A Frega
- Department of Medical and Surgical Science and Translational Medicine, Sant'Andrea Hospital, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy.
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di Martino O, Troiano A, Addi L, Guarino A, Calabrò S, Tudisco R, Murru N, Cutrignelli MI, Infascelli F, Calabrò V. Regulation of Stearoyl Coenzyme A Desaturase 1 Gene Promoter in Bovine Mammary Cells. Anim Biotechnol 2016; 26:251-9. [PMID: 26158455 DOI: 10.1080/10495398.2015.1022182] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Stearoyl-Coenzyme A desaturase 1 (SCD1) belongs to the fatty acid family of desaturases. In lactating ruminants, the SCD1 protein is highly expressed in the mammary gland and is relevant for the fatty acid composition of milk and dairy products. Bovine mammary epithelial cells (BME-UV1), cultured in vitro, have been proposed as a model to reproduce the biology of the mammary gland. The present study was designed to investigate the responsiveness of bovine SCD1 promoter to serum, insulin, oleic acid, and NFY transcription factor in BME-UV1 cells. A luciferase-based reporter assay was used to monitor the transcriptional activity of the SCD1 promoter region in BME-UV1 cells treated or not with insulin and/or oleic acid. The level of endogenous SCD1 mRNA was evaluated by Real time PCR. Insulin (20 ng/mL) induced a 2.0 to 2.5-fold increase of SCD1 promoter activity. Additionally, the effect of insulin was inhibited by oleic acid, serum components, and NFY enforced expression. Serum and NFY showed no synergistic or additive effect on SCD1 promoter activity suggesting that they repress SCD1 transcription through the same responsive element.
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Affiliation(s)
- O di Martino
- a Department of Biology , University of Naples "Federico II" , Naples , Italy
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Affiliation(s)
- G Fusco
- Department of Animal Health, Experimental Zooprophylactic Institute of Southern Italy, Via Salute, 2, Portici NA 80055, Italy
| | - M G Amoroso
- Department of Animal Health, Experimental Zooprophylactic Institute of Southern Italy, Via Salute, 2, Portici NA 80055, Italy
| | - G Aprea
- Department of Food Hygiene and Technology, Experimental Zooprophylactic Institute of Abruzzo and Molise 'G. Caporale', via Campo Boario, Teramo 64100, Italy
| | - V Veneziano
- Department of Pathology and Animal Health, University of Naples 'Federico II', Via Delpino, 1, Naples 80137, Italy
| | - A Guarino
- Department of Animal Health, Experimental Zooprophylactic Institute of Southern Italy, Via Salute, 2, Portici NA 80055, Italy
| | - G Galiero
- Department of Animal Health, Experimental Zooprophylactic Institute of Southern Italy, Via Salute, 2, Portici NA 80055, Italy
| | - M Viscardi
- Department of Animal Health, Experimental Zooprophylactic Institute of Southern Italy, Via Salute, 2, Portici NA 80055, Italy
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Pierannunzii L, Guarino A. Subradiological cam deformity of the head-neck junction: an occult cause of hip pain and chondrolabral damage. Musculoskelet Surg 2015; 99:113-9. [PMID: 25862256 DOI: 10.1007/s12306-015-0368-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 04/03/2015] [Indexed: 11/24/2022]
Abstract
PURPOSE The goal of this study was to determine how frequently the conventionally defined "idiopathic" chondrolabral hip injuries are associated with subradiological cam deformities of the head-neck junction and whether a protective femoral osteochondroplasty may improve the outcome of their arthroscopic treatment. METHODS All the non-arthritic or pre-arthritic painful hips diagnosed as having a primary chondrolabral injury were retrospectively evaluated. Coxometric data, clinical history and physical findings were reviewed to rule out any possible secondary lesion. The medical records of the selected cases were analyzed as for imaging features, surgical findings and post-arthroscopy outcome. RESULTS Three cases out of 79 chondrolabral injuries were identified as "primary" on the basis of the preoperative assessment. All the three patients were female in their fourth decade and showed a joint damage consistent with undetected cam FAI (cartilage delamination in the anterolateral acetabular quadrant, minor pathology of the adjacent labrum with or without chondrolabral separation, abrasion signs and herniation pits along the anterolateral head-neck junction). The first patient received a simple chondrolabral treatment whose benefits deteriorated few months after surgery; the second patient underwent chondrolabral repair and femoral osteochondroplasty and is still pain-free; and the third patient had a beneficial revision arthroscopy for femoral osteochondroplasty after prior unsuccessful chondrolabral surgery. CONCLUSIONS If a chondrolabral injury of the hip is associated with MR arthrographic and arthroscopic indirect signs of cam FAI, a subradiological head-neck deformity should be considered despite normal alpha angles. In such cases, a protective femoral osteochondroplasty may increase the success rate of the chondrolabral repair. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- L Pierannunzii
- Gaetano Pini Orthopaedic Institute, P.zza C. Ferrari, 1, 20122, Milan, Italy,
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Yazdanian D, Fuggetta E, Ticino A, Guarino A, Resta S, Porpora M. Fertility Outcome after Laparoscopic Treatment of Endometriosis in Infertile Women. J Minim Invasive Gynecol 2014. [DOI: 10.1016/j.jmig.2014.08.276] [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: 11/17/2022]
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Tinl M, Kale M, Doshi S, Guarino A, Beninato M. The Mobility Scale for Acute Stroke predicts discharge destination after acute hospitalization. J Rehabil Med 2014; 46:219-24. [DOI: 10.2340/16501977-1269] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Abstract
BACKGROUND In 2008, the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) and the European Society of Paediatric Infectious Disease (ESPID) developed evidence-based guidelines for the management of acute gastroenteritis (AGE) in children in Europe. AIM To summarise data published subsequently to the ESPGHAN/ESPID guidelines. METHODS MEDLINE and The Cochrane Library were searched in August 2012 for randomised controlled trials (RCTs) or their meta-analyses published after 2008. RESULTS Efforts to improve the taste and/or efficacy of oral rehydration solution (ORS) continue, and some interventions are promising. While standard (over 24 h) nasogastric rehydration is still being used, new evidence confirms that rapid (over 4 h) rehydration is also effective. For intravenous rehydration, new evidence is available regarding rapid or ultrarapid and large-volume vs. standard-volume rehydration; as the new evidence is not consistent, until more data are available, the administration of 20 mL/kg seems appropriate. Convincing evidence has accumulated showing that ondansetron reduces the risk for vomiting; however, a clearance on safety in children is needed. New evidence has reconfirmed that in Europe, where zinc deficiency is rare, there is no benefit from the use of zinc. New data, although mainly from outside of Europe, have reconfirmed that either smectite or racecadotril is an effective adjunctive therapy to oral rehydration. There is a clear effect of using certain probiotics, such as Lactobacillus GG or S. boulardii. CONCLUSIONS The update of current ESPGHAN/ESPID recommendations is warranted.
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Affiliation(s)
- M Pieścik-Lech
- Department of Paediatrics, The Medical University of Warsaw, Dzialdowska 1, Warsaw, Poland
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Merli G, Guarino A. Percutaneous tracheostomy: are we going to close the loop? Minerva Anestesiol 2013; 79:116-118. [PMID: 23254169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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Merli G, Guarino A, Petrini F, Sorbello M, Frova G. Should we really consider to lay down the Macintosh laryngoscope? Minerva Anestesiol 2012; 78:1078-1079. [PMID: 22467052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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Lucivero G, Romano C, Ferraraccio F, Sellitto A, De Fanis U, Giunta R, Guarino A, Auriemma PP, Benincasa M, Iovino F. Lupus mastitis in systemic lupus erythematosus: a rare condition requiring a minimally invasive diagnostic approach. Int J Immunopathol Pharmacol 2012; 24:1125-9. [PMID: 22230423 DOI: 10.1177/039463201102400435] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Breast involvement is a rare event in SLE patients. The most frequent presentation is lupus panniculitis with skin erythema, tenderness, and parenchymal nodules. However, when breast masses are detected in SLE patients without significant superficial inflammation, it is mandatory to rule out breast carcinoma. Here, we report the case of a 47-year-old woman with an 18-year-long history of SLE, who presented with a suspicious breast mass. Since surgical trauma has been reported to be able to exacerbate breast inflammation in lupus mastitis, an ultrasound-guided minimally invasive Mammotome biopsy was performed to obtain tissue samples for histological and immunohistochemical examinations. Histology was consistent with lupus mastitis. The patient was already on mycophenolate mofetil and hydroxychloroquine. At the latest follow-up visit 6 years later, no progression of the breast lesion was observed.
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Spagnuolo MI, Russo G, Giardino G, Caiazzo MA, Cirillo E, Ranucci G, Guarino A, Martire B, Vecchione R, Di Matteo G, Postorivo D, Pignata C. Chronic granulomatous disease with gastrointestinal presentation: diagnostic pitfalls and novel ultrastructural findings. J Investig Allergol Clin Immunol 2012; 22:527-529. [PMID: 23397679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Affiliation(s)
- M I Spagnuolo
- Department of Pediatrics, University Federico II, Naples, Italy
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Proroga Y, Casalinuovo F, Mancusi A, Gagliardi R, Rippa P, Albano F, Damiani V, Squillaro D, Guarino A, Capuano F. PRELIMINARY STUDY ON THE PREVALENCE OF COXIELLA BURNETII IN CHEESES PRODUCED IN SOUTHERN ITALY. Ital J Food Saf 2011. [DOI: 10.4081/ijfs.2011.2.71] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Formato M, Lepedda A, Zinellu E, Cigliano A, Piredda F, Bacciu P, Guarino A, Spirito R. 73 APOLIPOPROTEIN PROFILES IN ATHEROSCLEROTIC DISEASE. ATHEROSCLEROSIS SUPP 2011. [DOI: 10.1016/s1567-5688(11)70074-5] [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: 10/18/2022]
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Giaquinto C, Penazzato M, Rosso R, Bernardi S, Rampon O, Nasta P, Ammassari A, Antinori A, Badolato R, Castelli Gattinara G, d'Arminio Monforte A, De Martino M, De Rossi A, Di Gregorio P, Esposito S, Fatuzzo F, Fiore S, Franco A, Gabiano C, Galli L, Genovese O, Giacomet V, Giannattasio A, Gotta C, Guarino A, Martino A, Mazzotta F, Principi N, Regazzi MB, Rossi P, Russo R, Saitta M, Salvini F, Trotta S, Viganò A, Zuccotti G, Carosi G. Italian consensus statement on paediatric HIV infection. Infection 2010; 38:301-19. [PMID: 20514509 DOI: 10.1007/s15010-010-0020-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [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: 08/06/2009] [Accepted: 03/17/2010] [Indexed: 02/01/2023]
Abstract
The objective of this document is to identify and reinforce current recommendations concerning the management of HIV infection in infants and children in the context of good resource availability. All recommendations were graded according to the strength and quality of the evidence and were voted on by the 57 participants attending the first Italian Consensus on Paediatric HIV, held in Siracusa in 2008. Paediatricians and HIV/AIDS care specialists were requested to agree on different statements summarizing key issues in the management of paediatric HIV. The comprehensive approach on preventing mother-to-child transmission (PMTCT) has clearly reduced the number of children acquiring the infection in Italy. Although further reduction of MTCT should be attempted, efforts to personalize intervention to specific cases are now required in order to optimise the treatment and care of HIV-infected children. The prompt initiation of treatment and careful selection of first-line regimen, taking into consideration potency and tolerance, remain central. In addition, opportunistic infection prevention, adherence to treatment, and long-term psychosocial consequences are becoming increasingly relevant in the era of effective antiretroviral combination therapies (ART). The increasing proportion of infected children achieving adulthood highlights the need for multidisciplinary strategies to facilitate transition to adult care and maintain strategies specific to perinatally acquired HIV infection.
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Affiliation(s)
- C Giaquinto
- Dipartimento di Pediatria, Università degli Studi di Padova, Padova, Italy
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