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Peruzzotti-Jametti L, Willis CM, Krzak G, Hamel R, Pirvan L, Ionescu RB, Reisz JA, Prag HA, Garcia-Segura ME, Wu V, Xiang Y, Barlas B, Casey AM, van den Bosch AMR, Nicaise AM, Roth L, Bates GR, Huang H, Prasad P, Vincent AE, Frezza C, Viscomi C, Balmus G, Takats Z, Marioni JC, D'Alessandro A, Murphy MP, Mohorianu I, Pluchino S. Mitochondrial complex I activity in microglia sustains neuroinflammation. Nature 2024; 628:195-203. [PMID: 38480879 PMCID: PMC10990929 DOI: 10.1038/s41586-024-07167-9] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 02/06/2024] [Indexed: 03/17/2024]
Abstract
Sustained smouldering, or low-grade activation, of myeloid cells is a common hallmark of several chronic neurological diseases, including multiple sclerosis1. Distinct metabolic and mitochondrial features guide the activation and the diverse functional states of myeloid cells2. However, how these metabolic features act to perpetuate inflammation of the central nervous system is unclear. Here, using a multiomics approach, we identify a molecular signature that sustains the activation of microglia through mitochondrial complex I activity driving reverse electron transport and the production of reactive oxygen species. Mechanistically, blocking complex I in pro-inflammatory microglia protects the central nervous system against neurotoxic damage and improves functional outcomes in an animal disease model in vivo. Complex I activity in microglia is a potential therapeutic target to foster neuroprotection in chronic inflammatory disorders of the central nervous system3.
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Affiliation(s)
- L Peruzzotti-Jametti
- Department of Clinical Neurosciences and NIHR Biomedical Research Centre, University of Cambridge, Cambridge, UK.
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.
| | - C M Willis
- Department of Clinical Neurosciences and NIHR Biomedical Research Centre, University of Cambridge, Cambridge, UK
| | - G Krzak
- Department of Clinical Neurosciences and NIHR Biomedical Research Centre, University of Cambridge, Cambridge, UK
| | - R Hamel
- Department of Clinical Neurosciences and NIHR Biomedical Research Centre, University of Cambridge, Cambridge, UK
| | - L Pirvan
- Wellcome-MRC Cambridge Stem Cell Institute, University of Cambridge, Cambridge, UK
| | - R-B Ionescu
- Department of Clinical Neurosciences and NIHR Biomedical Research Centre, University of Cambridge, Cambridge, UK
| | - J A Reisz
- Department of Biochemistry and Molecular Genetics, University of Colorado School of Medicine, Aurora, CO, USA
| | - H A Prag
- MRC Mitochondrial Biology Unit, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
| | - M E Garcia-Segura
- Department of Clinical Neurosciences and NIHR Biomedical Research Centre, University of Cambridge, Cambridge, UK
| | - V Wu
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - Y Xiang
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - B Barlas
- Department of Clinical Neurosciences and NIHR Biomedical Research Centre, University of Cambridge, Cambridge, UK
- UK Dementia Research Institute, University of Cambridge, Cambridge, UK
| | - A M Casey
- MRC Mitochondrial Biology Unit, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
| | - A M R van den Bosch
- Department of Clinical Neurosciences and NIHR Biomedical Research Centre, University of Cambridge, Cambridge, UK
| | - A M Nicaise
- Department of Clinical Neurosciences and NIHR Biomedical Research Centre, University of Cambridge, Cambridge, UK
| | - L Roth
- Department of Clinical Neurosciences and NIHR Biomedical Research Centre, University of Cambridge, Cambridge, UK
| | - G R Bates
- MRC Mitochondrial Biology Unit, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
| | - H Huang
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - P Prasad
- Department of Clinical Neurosciences and NIHR Biomedical Research Centre, University of Cambridge, Cambridge, UK
| | - A E Vincent
- Wellcome Centre for Mitochondrial Research, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - C Frezza
- University Hospital Cologne, Cologne, Germany
| | | | - G Balmus
- Department of Clinical Neurosciences and NIHR Biomedical Research Centre, University of Cambridge, Cambridge, UK
- UK Dementia Research Institute, University of Cambridge, Cambridge, UK
- Department of Molecular Neuroscience, Transylvanian Institute of Neuroscience, Cluj-Napoca, Romania
| | - Z Takats
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - J C Marioni
- European Molecular Biology Laboratory, European Bioinformatics Institute, EMBL-EBI, Wellcome Genome Campus, Hinxton, UK
| | - A D'Alessandro
- Department of Biochemistry and Molecular Genetics, University of Colorado School of Medicine, Aurora, CO, USA
| | - M P Murphy
- MRC Mitochondrial Biology Unit, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
| | - I Mohorianu
- Wellcome-MRC Cambridge Stem Cell Institute, University of Cambridge, Cambridge, UK
| | - S Pluchino
- Department of Clinical Neurosciences and NIHR Biomedical Research Centre, University of Cambridge, Cambridge, UK.
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2
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Colonna S, Borghi C, Galvani M, D'Alessandro A. Immediate Effect of Simulated High Heels on Pelvic and Spinal Posture in Healthy Young Subjects: A Cross-Sectional Study. Cureus 2024; 16:e55586. [PMID: 38576640 PMCID: PMC10994651 DOI: 10.7759/cureus.55586] [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] [Subscribe] [Scholar Register] [Accepted: 03/05/2024] [Indexed: 04/06/2024] Open
Abstract
Background Investigations regarding the role of high-heeled shoes in the alteration of the spinopelvic profile attempted to identify a correlation with pain in the lower back. Conclusions from these studies, however, are controversial. In authors knowledge no studies were carried out to investigate the effect of heels on male population, which has been overlooked due to gender-related customs. Research question What is the immediate effect of the height of heels on the sagittal back profile (trunk inclination (TI), pelvic inclination, lordotic lumbar angle (ITL-ILS), kyphotic dorsal angle, lumbar arrow, and cervical arrow) in females and males, not used to wearing high-heeled shoes? Methods One hundred healthy young adult subjects were enrolled. Three were excluded. The remaining 97 subjects (48 female and 49 male) underwent a three-dimensional analysis of the posterior surface of the trunk, using rasterstereography. The spinopelvic profile in the barefoot condition, and with the heel raised by 3 and 7 cm, was recorded. To evaluate the reproducibility of the measure, the neutral evaluation was repeated twice in 23 subjects (13 males, 10 females). Results The change of heel height did not show statistically significant differences for any of the variables used; instead, significant differences were found stratifying the results according to the sex of the subjects tested. Test-retest evaluation in the neutral condition showed no significant differences using the Student's t-test (p > 0.05). Repeatability was excellent and significant for all data used (minimum TI r = 0.85, maximum ITL-ILS r = 0.97). Significance Studying the effect of heels on the spino-pelvic profile also in the male population is crucial for promoting gender-inclusive healthcare, enhancing occupational health practices and developing possible preventive measures. Nevertheless, in the sample of females and males evaluated in this study, the different heights of heel lift did not immediately induce significant changes in pelvis and spine posture. If there is therefore a correlation between low-back pain and the use of heels, it should not reasonably be sought in the immediate change of the spino-pelvic profile caused by raising the heels. However, the variables analyzed differed according to sex.
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Affiliation(s)
- Saverio Colonna
- Osteopathic Spine Center Education (OSCE), Spine Center, Bologna, ITA
| | - Corrado Borghi
- Osteopathic Spine Center Education (OSCE), Spine Center, Bologna, ITA
| | - Matteo Galvani
- Osteopathic Spine Center Education (OSCE), Spine Center, Bologna, ITA
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Freire CM, King NR, Dzieciatkowska M, Stephenson D, Moura PL, Dobbe JGG, Streekstra GJ, D'Alessandro A, Toye AM, Satchwell TJ. Complete absence of GLUT1 does not impair human terminal erythroid differentiation. bioRxiv 2024:2024.01.10.574621. [PMID: 38293086 PMCID: PMC10827085 DOI: 10.1101/2024.01.10.574621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
The Glucose transporter 1 (GLUT1) is one of the most abundant proteins within the erythrocyte membrane and is required for glucose and dehydroascorbic acid (Vitamin C precursor) transport. It is widely recognized as a key protein for red cell structure, function, and metabolism. Previous reports highlighted the importance of GLUT1 activity within these uniquely glycolysis-dependent cells, in particular for increasing antioxidant capacity needed to avoid irreversible damage from oxidative stress in humans. However, studies of glucose transporter roles in erythroid cells are complicated by species-specific differences between humans and mice. Here, using CRISPR-mediated gene editing of immortalized erythroblasts and adult CD34+ hematopoietic progenitor cells, we generate committed human erythroid cells completely deficient in expression of GLUT1. We show that absence of GLUT1 does not impede human erythroblast proliferation, differentiation, or enucleation. This work demonstrates for the first-time generation of enucleated human reticulocytes lacking GLUT1. The GLUT1-deficient reticulocytes possess no tangible alterations to membrane composition or deformability in reticulocytes. Metabolomic analyses of GLUT1-deficient reticulocytes reveal hallmarks of reduced glucose import, downregulated metabolic processes and upregulated AMPK-signalling, alongside alterations in antioxidant metabolism, resulting in increased osmotic fragility and metabolic shifts indicative of higher oxidant stress. Despite detectable metabolic changes in GLUT1 deficient reticulocytes, the absence of developmental phenotype, detectable proteomic compensation or impaired deformability comprehensively alters our understanding of the role of GLUT1 in red blood cell structure, function and metabolism. It also provides cell biological evidence supporting clinical consensus that reduced GLUT1 expression does not cause anaemia in GLUT1 deficiency syndrome.
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Affiliation(s)
- C M Freire
- School of Biochemistry, University of Bristol, Bristol, UK
| | - N R King
- School of Biochemistry, University of Bristol, Bristol, UK
| | - M Dzieciatkowska
- Department of Biochemistry and Molecular Genetics, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - D Stephenson
- Department of Biochemistry and Molecular Genetics, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - P L Moura
- Center for Haematology and Regenerative Medicine, Department of Medicine (MedH), Karolinska Institutet, Huddinge, Sweden
| | - J G G Dobbe
- Amsterdam UMC location University of Amsterdam, Biomedical Engineering and Physics, Meibergdreef 9, Amsterdam, the Netherlands
| | - G J Streekstra
- Amsterdam UMC location University of Amsterdam, Biomedical Engineering and Physics, Meibergdreef 9, Amsterdam, the Netherlands
| | - A D'Alessandro
- Department of Biochemistry and Molecular Genetics, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - A M Toye
- School of Biochemistry, University of Bristol, Bristol, UK
| | - T J Satchwell
- School of Biochemistry, University of Bristol, Bristol, UK
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Peruzzotti-Jametti L, Willis CM, Hamel R, Krzak G, Reisz JA, Prag HA, Wu V, Xiang Y, van den Bosch AMR, Nicaise AM, Roth L, Bates GR, Huang H, Vincent AE, Frezza C, Viscomi C, Marioni JC, D'Alessandro A, Takats Z, Murphy MP, Pluchino S. Mitochondrial reverse electron transport in myeloid cells perpetuates neuroinflammation. bioRxiv 2024:2024.01.03.574059. [PMID: 38260262 PMCID: PMC10802366 DOI: 10.1101/2024.01.03.574059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
Sustained smouldering, or low grade, activation of myeloid cells is a common hallmark of several chronic neurological diseases, including multiple sclerosis (MS) 1 . Distinct metabolic and mitochondrial features guide the activation and the diverse functional states of myeloid cells 2 . However, how these metabolic features act to perpetuate neuroinflammation is currently unknown. Using a multiomics approach, we identified a new molecular signature that perpetuates the activation of myeloid cells through mitochondrial complex II (CII) and I (CI) activity driving reverse electron transport (RET) and the production of reactive oxygen species (ROS). Blocking RET in pro-inflammatory myeloid cells protected the central nervous system (CNS) against neurotoxic damage and improved functional outcomes in animal disease models in vivo . Our data show that RET in myeloid cells is a potential new therapeutic target to foster neuroprotection in smouldering inflammatory CNS disorders 3 .
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Ross RB, Yu J, Gadwa J, Darragh LB, Knitz M, Nguyen D, Hoen M, Olimpo N, Corbo S, D'Alessandro A, Karam SD. Enhancing Immune-Mediated Radiotherapy Efficacy in Murine Models of Head and Neck Cancer through Peroxisome Proliferator-Activated Receptor Modulation. Int J Radiat Oncol Biol Phys 2023; 117:S103. [PMID: 37784273 DOI: 10.1016/j.ijrobp.2023.06.059] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) The tumor microenvironment (TME) in HPV-unrelated head and neck cancer (HNC) is considered to be immunologically "cold," and immunometabolic adaptations to radiotherapy (RT) can exacerbate these conditions and lead to radioresistance. Peroxisome proliferator-activated receptor-α (PPARα) agonism may improve the immune response to RT by reducing glucose scarcity through upregulation of fatty acid utilization in cancer cells. Our clinical trial data shows that high serum oleic acid (OA), a PPAR ligand, correlates with response to radioimmunotherapy. MATERIALS/METHODS Orthotopic buccal tumor implantations of MOC2 and LY2 HNC cell lines were performed in C57BL/6 and BALB/c mice, respectively. Mice were placed on a high OA diet (38% kcal from OA) 3 weeks prior to tumor implantation. Control diet consisted of 1% kcal from OA. In vitro RT was performed to characterize the metabolic effects on the cancer cell lines. For in vivo studies, tumors were irradiated upon reaching 100 mm^3 with three 8 Gy fractions, given every 4-5 days. The PPARα agonist fenofibrate (FF, 100mg/kg/day) was given via oral gavage or intraperitoneal injection starting 5 days after RT. Tumor volume and overall survival were measured as objective outcomes, and flow cytometry was used to characterize the immune landscape of the tumor, blood, and lymph nodes. Mass spectrometry was employed for bulk proteomics and metabolomics on serum samples, and stable isotope labeling was performed on CD8 T cells from treated mice ex vivo. Extracellular flux analyses were performed on tumor cells and CD8 T cells to determine metabolic phenotypic changes. RESULTS In vitro cytotoxicity was met for MOC2 and LY2 cancer cells in 100 uM FF and OA in comparison to solvent (p<0.01). Extracellular flux analyses show that RT upregulates the glycolytic phenotype of MOC2 and LY2 cancer cells; and that FF and/or OA decrease the glycolytic capacity of the cancer cells. Ex vivo extracellular flux analyses showed increased glycolytic capacity of CD8 T cells in mice treated with FF in comparison to RT alone. RT in combination with FF significantly improved tumor volume response in comparison to RT alone (mean 99.4 vs 182.7 mm^3, p = 0.001) and was comparable to combination radioimmunotherapy (with anti-PDL1 therapy; mean 99.4 vs. 132.3 mm^3). Unexpectedly, OA negated this improvement in efficacy in both MOC2 and LY2 tumor models; mice on the high OA diet had significantly higher average body weight (p<0.01). Significant changes in adaptive immune response were observed within the TME with the addition of FF. This was mirrored by changes in serum metabolomics. CONCLUSION PPARα agonism improved the efficacy of RT in murine HNC models and could be considered in future translational clinical trial design.
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Affiliation(s)
- R B Ross
- Department of Radiation Oncology, University of Colorado, Aurora, CO
| | - J Yu
- Department of Otolaryngology, University of Colorado, Aurora, CO
| | - J Gadwa
- Department of Radiation Oncology, University of Colorado, Aurora, CO
| | - L B Darragh
- Department of Radiation Oncology, University of Colorado, Aurora, CO
| | - M Knitz
- Department of Radiation Oncology, University of Colorado, Aurora, CO
| | - D Nguyen
- Department of Radiation Oncology, University of Colorado, Aurora, CO
| | - M Hoen
- Department of Radiation Oncology, University of Colorado, Aurora, CO
| | - N Olimpo
- Department of Radiation Oncology, University of Colorado, Aurora, CO
| | - S Corbo
- Department of Radiation Oncology, University of Colorado, Aurora, CO
| | - A D'Alessandro
- Department of Biochemistry and Molecular Genetics, University of Colorado, Aurora, CO
| | - S D Karam
- Department of Radiation Oncology, University of Colorado, Aurora, CO
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Barucca L, Hering W, Perez Martin S, Bubelis E, Del Nevo A, Di Prinzio M, Caramello M, D'Alessandro A, Tarallo A, Vallone E, Moscato I, Quartararo A, D'amico S, Giannetti F, Lorusso P, Narcisi V, Ciurluini C, Montes Pita M, Sánchez C, Rovira A, Santana D, Gonzales P, Barbero R, Zaupa M, Szogradi M, Normann S, Vaananen M, Ylatalo J, Lewandowska M, Malinowski L, Martelli E, Froio A, Arena P, Tincani A. Maturation of critical technologies for the DEMO balance of plant systems. Fusion Engineering and Design 2022. [DOI: 10.1016/j.fusengdes.2022.113096] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Boscolo-Rizzo P, Hummel T, Hopkins C, Dibattista M, Menini A, Spinato G, Fabbris C, Emanuelli E, D'Alessandro A, Marzolino R, Zanelli E, Cancellieri E, Cargnelutti K, Fadda S, Borsetto D, Vaira LA, Gardenal N, Polesel J, Tirelli G. High prevalence of long-term olfactory, gustatory, and chemesthesis dysfunction in post-COVID-19 patients: a matched case-control study with one-year follow-up using a comprehensive psychophysical evaluation. Rhinology 2021; 59:517-527. [PMID: 34553706 DOI: 10.4193/rhin21.249] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Using an age and gender matched-pair case-control study, we aimed to estimate the long-term prevalence of psychophysical olfactory, gustatory , and chemesthesis impairment at least one year after SARS-CoV-2 infection considering the background of chemosensory dysfunction in non-COVID-19 population. METHODOLOGY This case-controlled study included 100 patients who were home-isolated for mildly symptomatic COVID-19 between March and April 2020. One control regularly tested for SARS-CoV-2 infection and always tested negative was matched to each case according to gender and age. Chemosensory function was investigated by a comprehensive psychophysical evaluation including ortho- and retronasal olfaction and an extensive assessment of gustatory function. Differences in chemosensory parameters were evaluated through either Fisher's exact test or Kruskal-Wallis test. RESULTS The psychophysical assessment of chemosensory function took place after a median of 401 days from the first SARS-CoV-2 positive swab. The evaluation of orthonasal smell identified 46% and 10% of cases and controls, respectively, having olfactory dysfunction, with 7% of COVID-19 cases being functionally anosmic. Testing of gustatory function revealed a 27% of cases versus 10% of controls showing a gustatory impairment. Nasal trigeminal sensitivity was significantly lower in cases compared to controls. Persistent chemosensory impairment was associated with emotional distress and depression. CONCLUSION More than one year after the onset of COVID-19, cases exhibited an excess of olfactory, gustatory , and chemesthesis disturbances compared to matched-pair controls with these symptoms being associated to emotional distress and depression.
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Affiliation(s)
- P Boscolo-Rizzo
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy
| | - T Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, Technical University of Dresden, Dresden, Germany
| | - C Hopkins
- Guy's and St Thomas' Hospitals, London, United Kingdom
| | - M Dibattista
- Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University of Bari A. Moro, Bari, Italy
| | - A Menini
- Neurobiology Group, SISSA, Scuola Internazionale Superiore di Studi Avanzati, Trieste, Italy
| | - G Spinato
- Unit of Otolaryngology, AULSS 2 - Marca Trevigiana, Treviso, Italy.,Department of Neurosciences, Section of Otolaryngology, University of Padova, Treviso, Italy.,Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy
| | - C Fabbris
- Unit of Otolaryngology, AULSS 2 - Marca Trevigiana, Treviso, Italy
| | - E Emanuelli
- Unit of Otolaryngology, AULSS 2 - Marca Trevigiana, Treviso, Italy
| | - A D'Alessandro
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy
| | - R Marzolino
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy
| | - E Zanelli
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy
| | - E Cancellieri
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy
| | - K Cargnelutti
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy
| | - S Fadda
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy
| | - D Borsetto
- Department of ENT, Addenbrookes Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - L A Vaira
- Department of Medical, Surgical and Experimental Sciences, Maxillofacial Surgery Operative Unit, University of Sassari, Sassari, Italy
| | - N Gardenal
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy
| | - J Polesel
- Unit of Cancer Epidemiology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - G Tirelli
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy
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Dirani M, Chahine E, D'Alessandro A, Chouillard MA, Gumbs AA, Chouillard E. The use of Permacol® biological mesh for complex abdominal wall repair. Minerva Surg 2021; 77:41-49. [PMID: 33890445 DOI: 10.23736/s2724-5691.21.08779-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Complex abdominal wall repair (CAWR) remains challenging, especially in contaminated fields where the use of a synthetic mesh is associated with prohibitively complication rates. Consequently, biological mesh has been proposed as an alternative. The aim of our study was to evaluate the safety and efficacy of using Permacol® in patients who had CAWR. METHODS We retrospectively reviewed the files of patients who had CAWR using the Permacol® mesh. Analysis included patients' preoperative characteristics, procedural parameters, and early and late post-operative complications including mainly recurrence. A multivariate regression model was performed to determine factors that influence 24-months recurrence rate. RESULTS Between January 2009 and December 2018, 75 patients. The most common indication was hernia in a contaminated field (48.0%) and abdominal wall defect greater than 10 cm in diameter (36%). Overall, 44% of our patients were Centers for Disease Control (CDC) class II or III and 81.3% fall into category II or III according to the Ventral Hernia Working Group (VHWG) classification. Recurrence rate of our series was 9.3%. Complete fascial closure was achieved in 60 patients (80%). Upon univariate analysis complete fascial closure, posterior component separation, seroma drainage, BMI >30 kg/m2 and age >65 years, VHWD grade >2, DINDO CLAVIEN class > 2 affected the recurrence rate at 2 years follow up. When subcutaneous drains are placed prophylactically, recurrence rates drop from 38.7% (5/14) to 3.3% (2/61 patients) when drains are placed at the time of operation (p=0.02). Only fascial closure affected the 24-months recurrence rate on multivariate analysis (p<0.001). CONCLUSIONS Permacol® surgical implant use for CAWR is safe with a relatively low rate of hernia recurrence at 2 years. Prophylactic subcutaneous drain placement may reduce the risk of hernia recurrence. The presence of contaminated fields does not appear to influence hernia recurrence when Permacol® is used, in fact, the only factor that affects recurrence rate at 24-months on multivariate analysis is completeness of the fascial closure.
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Affiliation(s)
- Mazen Dirani
- Department of General & Digestive Surgery, Poissy/Saint-Germain Medical Center, Poissy, France
| | - Elias Chahine
- Department of General & Digestive Surgery, Poissy/Saint-Germain Medical Center, Poissy, France
| | - Antonio D'Alessandro
- Department of General & Digestive Surgery, Poissy/Saint-Germain Medical Center, Poissy, France
| | - Marc-Anthony Chouillard
- Department of General & Digestive Surgery, Poissy/Saint-Germain Medical Center, Poissy, France
| | - Andrew A Gumbs
- Department of General & Digestive Surgery, Poissy/Saint-Germain Medical Center, Poissy, France
| | - Elie Chouillard
- Department of General & Digestive Surgery, Poissy/Saint-Germain Medical Center, Poissy, France -
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Chouillard E, Chahine E, D'Alessandro A, Vitte RL, Gumbs A, Kassir R. Roux-en-Y Gastro-jejunostomy for Complex Leak After the "Nissen" Variant of Sleeve Gastrectomy. Obes Surg 2021; 30:3642-3644. [PMID: 32458365 DOI: 10.1007/s11695-020-04731-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 12/17/2022]
Abstract
BACKGROUND Recently, improvised variants of sleeve gastrectomy SG were reported as alternative bariatric options in patients suffering from both morbid obesity and GERD, including mainly additional anterior or posterior fundoplication over a partially sleeved stomach. METHODS We present the case of a 29-year-old male patient with a body mass index (BMI) of 46.2 kg/m2 underwent laparoscopic SG with concomitant posterior fundoplication: Nissen-SG (N-SG). At postoperative day (POD) 4, he presented with epigastric pain, nausea, and 40 °C fever. The abdomen was tender with signs of peritonitis. Explorative laparotomy displayed a massive gastric leak with generalized peritonitis. Peritoneal lavage was performed. the patient was transferred to our department for the management of persistent SGL. RESULTS Initial management comprised total parenteral nutrition and wide-spectrum intravenous antibiotics. Three weeks later, the patient underwent laparoscopic exploration. As shown in the video, at least two leaks were individualized, including one, anterior, catheterized by the pigtails, and the other one, posterior, impossible to reach endoscopically (Fig. 1). A residual abscess, located between the left crus, the pancreas, and the upper edge of the spleen, was evacuated. Eventually, Roux-en-Y gastro-jejunostomy was performed CONCLUSION: The adjunction of a posterior fundoplication may have contributed to the multiple and complex occurrence of SGL. Having an ill-vascularized redundant fundus may have increased ischemia of the GE junction. Moreover, it is more difficult to perform endoscopic treatment in a plicated and sleeved stomach as well.
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Affiliation(s)
- Elie Chouillard
- Department of Minimally Invasive Surgery, Poissy Saint Germain Medical Center, Poissy, France
| | - Elias Chahine
- Department of Minimally Invasive Surgery, Poissy Saint Germain Medical Center, Poissy, France
| | - Antonio D'Alessandro
- Department of Minimally Invasive Surgery, Poissy Saint Germain Medical Center, Poissy, France
| | - René-Louis Vitte
- Department of Interventional Endoscopy, Poissy Saint Germain Medical Center, Poissy, France
| | - Andrew Gumbs
- Department of Minimally Invasive Surgery, Poissy Saint Germain Medical Center, Poissy, France
| | - Radwan Kassir
- Department of Bariatric Surgery, CHU Felix-Guyon, St-Denis, la Réunion, France.
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Cartillone M, Kassir R, Mis TC, Falsetti E, D'Alessandro A, Chahine E, Chouillard E. König's Syndrome After Roux-en-Y Gastric Bypass: Candy Cane Twist. Obes Surg 2021; 30:3251-3252. [PMID: 32377990 DOI: 10.1007/s11695-020-04563-8] [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] [Indexed: 11/28/2022]
Abstract
BACKGROUND A König's syndrome is referred to abdominal pain in relation to meals with constipation alternated with diarrhea, meteorism, and abdominal distension. A postoperative long-term complication after Roux-en-Y gastric bypass could be the appearance of chronic abdominal pain associated with vomiting, dysphagia, and nausea. CASE REPORT A 43-year-old female patient was submitted for a Roux-en-Y gastric bypass for morbid obesity with an initial body mass index (BMI) of 36 kg/m2 (weight 100 kg, height 168 cm). At the 5-year follow-up, the patient's BMI was 22.3 kg/m2 with a weight loss of 40 kg. In the last month, the patient has undergone a further weight loss of 8 kg (BMI 18.4 kg/m2) with the presence of chronic abdominal pain, dyspepsia, and dysphagia and abdominal distension. Any vasomotor problems (hot flushing, sweating, palpitations, and diarrhea) were described. The computer tomography (CT) with oral contrast shows the presence of a blind afferent Roux limb at the gastrojejunostomy, explaining a possible König's syndrome. RESULTS The patient was submitted for a diagnostic laparoscopy, which revealed the presence of a twisted candy cane that was identified and resected. The postoperative stages were uneventful and the patient was discharged on the second postoperative day. CONCLUSION Candy cane syndrome is a rare and challenging complication reported in bariatric patients following Roux-en-Y gastric bypass and is best investigated with a barium swallow or oesophago-gastro-duodenoscopy (OGD). This means that this kind of pathology could be avoided by not leaving such a long blind loop during the primary gastric bypass operation. An explorative laparoscopy could be performed in the event of abdominal pain, nausea, and vomiting at a long-term follow-up after gastric bypass. Even if there are little data regarding the efficacy of surgical treatment, if present, "candy cane" surgical revision seems to be the best treatment for the majority of the patients with long-term symptomatic relief.
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Affiliation(s)
- Mariacristina Cartillone
- Department of General and Digestive Surgery, Bariatric Surgery Unit, Poissy Saint Germain-en-laye, Saint Germain-en-laye, France
| | - Radwan Kassir
- Department of Digestive Surgery, CHU Félix Guyon, La réunion, St-Denis, France.
| | - Tommaso Cipolat Mis
- Department of General and Digestive Surgery, Bariatric Surgery Unit, Poissy Saint Germain-en-laye, Saint Germain-en-laye, France
| | - Elena Falsetti
- Department of General and Digestive Surgery, Bariatric Surgery Unit, Poissy Saint Germain-en-laye, Saint Germain-en-laye, France
| | - Antonio D'Alessandro
- Department of General and Digestive Surgery, Bariatric Surgery Unit, Poissy Saint Germain-en-laye, Saint Germain-en-laye, France
| | - Elias Chahine
- Department of General and Digestive Surgery, Bariatric Surgery Unit, Poissy Saint Germain-en-laye, Saint Germain-en-laye, France
| | - Elie Chouillard
- Department of General and Digestive Surgery, Bariatric Surgery Unit, Poissy Saint Germain-en-laye, Saint Germain-en-laye, France
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Papa A, Covino M, Pizzolante F, Miele L, Lopetuso LR, Bove V, Iorio R, Simeoni B, Vetrone LM, Tricoli L, Mignini I, Schepis T, D'Alessandro A, Coppola G, Nicoletti T, Visconti E, Rapaccini G. Gastrointestinal symptoms and digestive comorbidities in an Italian cohort of patients with COVID-19. Eur Rev Med Pharmacol Sci 2020; 24:7506-7511. [PMID: 32706091 DOI: 10.26355/eurrev_202007_21923] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE The Coronavirus Disease 2019 (COVID-19) pandemic mainly involves respiratory symptoms, though gastrointestinal (GI) symptoms are increasingly being recognized. In this context, the presence of comorbidities appears to be associated with adverse outcomes. However, the role of digestive manifestations is not yet well defined. The primary aim of this study was to assess the prevalence of GI symptoms and digestive comorbidities in a cohort of patients with COVID-19 compared to controls. The secondary aim was to determine the association of GI-symptoms and digestive comorbidities with clinical outcomes. PATIENTS AND METHODS Inpatients with COVID-19 and controls with similar symptoms and/or radiological findings were enrolled. Symptoms at admission and throughout hospitalization were collected as they were comorbidities. The measured clinical outcomes were mortality, intensive care unit admission and cumulative endpoint. RESULTS A total of 105 patients were included: 34 with COVID-19 and 71 controls. At admission, the prevalence of GI symptoms among COVID-19 patients was 8.8%. During hospitalization, the frequency of GI symptoms was higher in patients with COVID-19 than in controls (p=0.004). Among patients with COVID-19, the mortality and a cumulative endpoint rates of those with GI symptoms were both lower than for those without GI symptoms (p=0.016 and p=0.000, respectively). Finally, we found digestive comorbidities to be associated with a milder course of COVID-19 (p=0.039 for cumulative endpoint). CONCLUSIONS Our results highlighted the non-negligible frequency of GI symptoms in patients with COVID-19, partly attributable to the therapies implemented. In addition, the presence of GI symptoms and digestive comorbidities is associated with better outcomes. Most likely, digestive comorbidities do not hinder the host's immune response against SARS-COV-2, and the occurrence of GI symptoms might be linked to a faster reduction of the viral load via the faecal route.
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Affiliation(s)
- A Papa
- Gastroenterology Department, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy.
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12
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Napolitano F, D'Alessandro A, D'Ambrosio A, Angelillo IF. Attitudes and practices towards human papillomavirus vaccination among general practitioners in Italy. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky212.339] [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] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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13
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Affiliation(s)
- A. D'Alessandro
- Department of Biochemistry and Molecular Genetics; University of Colorado Denver; Aurora CO USA
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14
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Limongelli P, D'Alessandro A, Parisi S, Pirozzi R, Bondanese M, Colella C, Docimo G, Del Genio G, Del Genio A, Docimo L. Double loop reconstruction following pancreaticoduodenectomy for malignant tumor: Short-term outcome. Int J Surg Case Rep 2016; 20S:16-20. [PMID: 26872635 DOI: 10.1016/j.ijscr.2016.02.002] [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: 01/04/2023] Open
Abstract
BACKGROUND To evaluate the use of a double loop reconstruction following pylorus preserving proximal pancreaticoduodenectomy (PPPPD). METHODS Morbidity and mortality were evaluated in 55 patients undergoing PPPPD for malignant tumors, followed by a double loop reconstruction. RESULTS The mean intra-operative blood loss was 908mL±531. In-hospital mortality was 5.4% (3/55 pts). The mean length of hospital stay was 17±5 days (range 12-45 days). Postoperative complications occurred in 25 patients (46.2%). Five patients developed an anastomotic leak, one biliary and four pancreatic (4/55; 7%). Delayed gastric emptying occurred in 8 patients (14.5%). Reoperation was required in two patients for hemorrhage. CONCLUSIONS A double loop alimentary reconstruction following PPPPD led to a low incidence of DGE and pancreatic fistula. Although mortality rate was higher than that reported by referral centres, this technique has been performed in a not specialized unit attaining acceptable results.
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Affiliation(s)
- Paolo Limongelli
- XI Division of General and Obesity Surgery, Second University of Naples, Naples, Italy.
| | - A D'Alessandro
- XI Division of General and Obesity Surgery, Second University of Naples, Naples, Italy
| | - S Parisi
- XI Division of General and Obesity Surgery, Second University of Naples, Naples, Italy
| | - R Pirozzi
- XI Division of General and Obesity Surgery, Second University of Naples, Naples, Italy
| | - M Bondanese
- XI Division of General and Obesity Surgery, Second University of Naples, Naples, Italy
| | - C Colella
- XI Division of General and Obesity Surgery, Second University of Naples, Naples, Italy
| | - Giovanni Docimo
- XI Division of General and Obesity Surgery, Second University of Naples, Naples, Italy
| | - Gianmattia Del Genio
- XI Division of General and Obesity Surgery, Second University of Naples, Naples, Italy
| | - Alberto Del Genio
- XI Division of General and Obesity Surgery, Second University of Naples, Naples, Italy
| | - Ludovico Docimo
- XI Division of General and Obesity Surgery, Second University of Naples, Naples, Italy
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15
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Ruggiero R, Docimo L, Tolone S, De Palma M, Musella M, Pezzolla A, Gubitosi A, Parmeggiani D, Pirozzi R, Gili S, Parisi S, D'Alessandro A, Docimo G. Effectiveness of an advanced hemostatic pad combined with harmonic scalpel in thyroid surgery. A prospective study. Int J Surg 2015; 28 Suppl 1:S17-21. [PMID: 26708861 DOI: 10.1016/j.ijsu.2015.12.044] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 04/08/2015] [Revised: 04/26/2015] [Accepted: 05/15/2015] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Hemostasis during thyroidectomy is essential; however the most efficient and cost-effective way to achieve this is unclear. The aim of this study was to evaluate the outcome of total thyroidectomy (TT) performed with the combination of harmonic scalpel (HS) and an advanced hemostatic pad (Hemopatch). METHODS Patient undergone TT were divided into two groups: HS + hemopatch and HS + traditional hemostasis groups. The primary endpoint was 24-h drain output and blood-loss requiring reintervention. Secondary endpoints included surgery duration, postsurgical complications and hypocalcemia rates. RESULTS Between September 2014 and March 2015, 60 patients were enrolled (30 to Hs + Hemopatch, 30 to Hs and standard hemostasis); 71.4% female; mean age 48.5 years. The 24-h drain output was lower in the HS + hemopatch group compared with standard TT. HS and hemopatch also had a shorter mean surgery time (p < 0.0001) vs standard TT. CONCLUSION combination of hemopatch plus HS is effective and safe for TT with a complementary hemostatic approach.
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Affiliation(s)
- Roberto Ruggiero
- Division of Surgery, Department of Surgery, Second University of Naples, Naples, Italy.
| | - Ludovico Docimo
- Division of Surgery, Department of Surgery, Second University of Naples, Naples, Italy
| | - Salvatore Tolone
- Division of Surgery, Department of Surgery, Second University of Naples, Naples, Italy
| | | | - Mario Musella
- Division of Surgery, Department of Surgery, Federico II University, Naples, Italy
| | | | - Adelmo Gubitosi
- Division of Surgery, Department of Surgery, Second University of Naples, Naples, Italy
| | - Domenico Parmeggiani
- Division of Surgery, Department of Surgery, Second University of Naples, Naples, Italy
| | - Raffaele Pirozzi
- Division of Surgery, Department of Surgery, Second University of Naples, Naples, Italy
| | - Simona Gili
- Division of Surgery, Department of Surgery, Second University of Naples, Naples, Italy
| | - Simona Parisi
- Division of Surgery, Department of Surgery, Second University of Naples, Naples, Italy
| | - Antonio D'Alessandro
- Division of Surgery, Department of Surgery, Second University of Naples, Naples, Italy
| | - Giovanni Docimo
- Division of Surgery, Department of Surgery, Second University of Naples, Naples, Italy
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16
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Moore HB, Moore EE, Chapman MP, Gonzalez E, Slaughter AL, Morton AP, D'Alessandro A, Hansen KC, Sauaia A, Banerjee A, Silliman CC. Viscoelastic measurements of platelet function, not fibrinogen function, predicts sensitivity to tissue-type plasminogen activator in trauma patients. J Thromb Haemost 2015; 13:1878-87. [PMID: 26256459 PMCID: PMC4838414 DOI: 10.1111/jth.13067] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Accepted: 07/22/2015] [Indexed: 01/08/2023]
Abstract
BACKGROUND Systemic hyperfibrinolysis is a lethal phenotype of trauma-induced coagulopathy. Its pathogenesis is poorly understood. Recent studies have support a central role of platelets in hemostasis and in fibrinolysis regulation, implying that platelet impairment is integral to the development of postinjury systemic hyperfibrinolysis. OBJECTIVE The objective of this study was to identify if platelet function is associated with blood clot sensitivity to fibrinolysis. We hypothesize that platelet impairment of the ADP pathway correlates with fibrinolysis sensitivity in trauma patients. METHODS A prospective observational study of patients meeting the criteria for the highest level of activation at an urban trauma center was performed. Viscoelastic parameters associated with platelet function (maximum amplitude [MA]) were measured with native thrombelastography (TEG), and TEG platelet mapping of the ADP pathway (ADP-MA). The contribution of fibrinogen to clotting was measured with TEG (angle) and the TEG functional fibrinogen (FF) assay (FF-MA). Another TEG assay containing tissue-type plasminogen activator (t-PA) (75 ng mL(-1) ) was used to assess clot sensitivity to an exogenous fibrinolytic stimulus by use of the TEG lysis at 30 min (LY30) variable. Multivariate linear regression was used to identify which TEG variable correlated with t-PA-LY30 (quantification of fibrinolysis sensitivity). RESULTS Fifty-eight trauma patients were included in the analysis, with a median injury severity score of 17 and a base deficit of 6 mEq L(-1) . TEG parameters that significantly predicted t-PA-LY30 were related to platelet function (ADP-MA, P = 0.001; MA, P < 0.001) but not to fibrinogen (FF-MA, P = 0.773; angle, P = 0.083). Clinical predictors of platelet ADP impairment included calcium level (P = 0.001), base deficit (P = 0.001), and injury severity (P = 0.001). RESULTS AND CONCLUSIONS Platelet impairment of the ADP pathway is associated with increased sensitivity to t-PA. ADP pathway inhibition in platelets may be an early step in the pathogenesis of systemic hyperfibrinolysis.
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Affiliation(s)
- H B Moore
- Department of Surgery, University of Colorado, Aurora, CO, USA
- Denver Health Medical Center, Denver, CO, USA
| | - E E Moore
- Department of Surgery, University of Colorado, Aurora, CO, USA
- Denver Health Medical Center, Denver, CO, USA
| | - M P Chapman
- Department of Surgery, University of Colorado, Aurora, CO, USA
- Denver Health Medical Center, Denver, CO, USA
| | - E Gonzalez
- Department of Surgery, University of Colorado, Aurora, CO, USA
- Denver Health Medical Center, Denver, CO, USA
| | - A L Slaughter
- Department of Surgery, University of Colorado, Aurora, CO, USA
- Denver Health Medical Center, Denver, CO, USA
| | - A P Morton
- Department of Surgery, University of Colorado, Aurora, CO, USA
- Denver Health Medical Center, Denver, CO, USA
| | - A D'Alessandro
- Department of Surgery, University of Colorado, Aurora, CO, USA
| | - K C Hansen
- Department of Surgery, University of Colorado, Aurora, CO, USA
| | - A Sauaia
- Department of Surgery, University of Colorado, Aurora, CO, USA
| | - A Banerjee
- Department of Surgery, University of Colorado, Aurora, CO, USA
| | - C C Silliman
- Department of Surgery, University of Colorado, Aurora, CO, USA
- Bonfils Blood Center, Denver, CO, USA
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17
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Brendolan A, Ronco C, Feriani M, Chiaramonte S, Bragantini L, Dal Santo M, Lora L, D'Alessandro A, La Greca G. Extracorporeal treatment of ascitic fluid and intraperitoneal reinfusion in patients with refractory ascites. Contrib Nephrol 2015; 93:241-4. [PMID: 1802589 DOI: 10.1159/000420228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- A Brendolan
- Department of Nephrology, St. Bortolo Hospital, Vicenza, Italy
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18
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D'Alessandro A, Hansen KC, Silliman CC, Moore EE, Kelher M, Banerjee A. Metabolomics of AS-5 RBC supernatants following routine storage. Vox Sang 2014; 108:131-40. [PMID: 25200932 DOI: 10.1111/vox.12193] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [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: 05/13/2014] [Revised: 07/16/2014] [Accepted: 08/11/2014] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND OBJECTIVES The safety and efficacy of stored red blood cells (RBCs) transfusion has been long debated due to retrospective clinical evidence and laboratory results, indicating a potential correlation between increased morbidity and mortality following transfusion of RBC units stored longer than 14 days. We hypothesize that storage in Optisol additive solution-5 leads to a unique metabolomics profile in the supernatant of stored RBCs. MATERIALS AND METHODS Whole blood was drawn from five healthy donors, RBC units were manufactured, and prestorage leucoreduced by filtration. Samples were taken on days 1 and 42, the cells removed, and mass spectrometry-based metabolomics was performed. RESULTS The results confirmed the progressive impairment of RBC energy metabolism by day 42 with indirect markers of a parallel alteration of glutathione and NADPH homeostasis. Moreover, oxidized pro-inflammatory lipids accumulated by the end of storage. CONCLUSION The supernatants from stored RBCs may represent a burden to the transfused recipients from a metabolomics standpoint.
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Affiliation(s)
- A D'Alessandro
- Department of Biochemistry and Molecular Genetics, School of Medicine University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, USA
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Tolone S, Docimo G, Del Genio G, Brusciano L, Verde I, Gili S, Vitiello C, D'Alessandro A, Casalino G, Lucido F, Leone N, Pirozzi R, Ruggiero R, Docimo L. Long term quality of life after laparoscopic antireflux surgery for the elderly. BMC Surg 2014. [PMID: 24267446 DOI: 10.1186/1471-2482-13-s2-s10\r1471-2482-13-s2-s10[pii]] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023] Open
Abstract
BACKGROUND Studies have previously shown laparoscopic antireflux surgery is a safe and effective treatment for GERD even in elderly patients. The aim of the current study was to evaluate patients receiving laparoscopic antireflux surgery before and after 65 years of age and to assess their surgical outcomes and improvements in long term quality of life. METHODS Patients were given a standardized symptoms questionnaire and the Short-Form 36 Health Survey for quality-of-life evaluation before and after laparoscopic total fundoplication. RESULTS Forty-nine patients older than 65 years of age were defined as the elderly group (EG) whereas the remaining 262 younger than 65 years of age were defined as the young group (YG). CONCLUSIONS In conclusion, laparoscopic total fundoplication is a safe and effective surgical treatment for gastroesophageal reflux disease generally warranting low morbidity and mortality rates and a significant improvement of symptoms comparable. An improved long-term quality of life is warranted even in the elderly.
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Pellecchia E, Antonini R, Bottai A, D'Alessandro A. Total nuclear disarmament: ethical and moral issues. Glob Bioeth 2014. [DOI: 10.1080/11287462.2014.924724] [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: 10/25/2022] Open
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21
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Limongelli P, Brusciano L, Di Stazio C, del Genio G, Tolone S, Lucido FS, Amoroso V, D'Alessandro A, Docimo G, Docimo L. D-shape asymmetric and symmetric excision with primary closure in the treatment of sacrococcygeal pilonidal disease. Am J Surg 2014; 207:882-9. [DOI: 10.1016/j.amjsurg.2013.06.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2013] [Revised: 06/20/2013] [Accepted: 06/20/2013] [Indexed: 10/26/2022]
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Tolone S, Roberto R, del Genio G, Brusciano L, Parmeggiani D, Amoroso V, Casalino G, Verde I, Bosco A, D'Alessandro A, Pirozzi R, Rossetti G, Limongelli P, Docimo L. The impact of age and oral calcium and vitamin D supplements on postoperative hypocalcemia after total thyroidectomy. A prospective study. BMC Surg 2013; 13 Suppl 2:S11. [PMID: 24267491 PMCID: PMC3851172 DOI: 10.1186/1471-2482-13-s2-s11] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background Hypocalcemia caused by transient or definitive hypoparathyroidism is the most frequent complication after total thyroidectomy (TT). We aimed to compare the impact of age and the clinical usefulness of oral calcium and vitamin D supplements on postoperative hypocalcemia after TT, and to determine which risk factors are important for hypocalcemia incidence. Methods Two hundred consecutive patients treated by TT were included prospectively in the present study. All patients supplemented oral calcium and vitamin D in the post-operative time. The data concerning symptomatic and laboratoristichypocalcemia were collected. Patients were evaluated according to age, sex, postoperative serum calcium levels, and preoperative serum alkaline phosphatasis levels. Results Symptomatic hypocalcemia developed only in 19 patients (9.5%), whereas laboratory hypocalcemia developed in 36 patients (18%). The risk for postoperative hypocalcemia was increate 20-fold for patients older than 50 years. Conclusions Age is significantly associated with postoperative hypocalcemia. Implementing oral calcium and vitamin D after total thyroidectomy can reduce the incidence of hypocalcemia related to surgery.
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Tolone S, Docimo G, Del Genio G, Brusciano L, Verde I, Gili S, Vitiello C, D'Alessandro A, Casalino G, Lucido F, Leone N, Pirozzi R, Ruggiero R, Docimo L. Long term quality of life after laparoscopic antireflux surgery for the elderly. BMC Surg 2013; 13 Suppl 2:S10. [PMID: 24267446 PMCID: PMC3851040 DOI: 10.1186/1471-2482-13-s2-s10] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background Studies have previously shown laparoscopic antireflux surgery is a safe and effective treatment for GERD even in elderly patients. The aim of the current study was to evaluate patients receiving laparoscopic antireflux surgery before and after 65 years of age and to assess their surgical outcomes and improvements in long term quality of life. Methods Patients were given a standardized symptoms questionnaire and the Short-Form 36 Health Survey for quality-of-life evaluation before and after laparoscopic total fundoplication. Results Forty-nine patients older than 65 years of age were defined as the elderly group (EG) whereas the remaining 262 younger than 65 years of age were defined as the young group (YG). There were 114 (36.6%) patients who filled out the SF36 questionnaire (98 in the younger group, rate: 37.4%; 16 in the elderly group, rate: 32.6%) pre- and post-operatively. There was no significant difference between the two age groups regarding preoperative PCS ( 45.6 ± 7.8 in YG vs. 44.2 ± 8.2 in EG; P = 0.51) and MCS ( 48.1 ± 10.7 in YG vs. 46.9 ± 9.2 in EG; P = 0.67). There was no significant difference between the two age groups regarding postoperative PCS (49.8 ± 11.9 in YG and 48.2 ± 9.5 in EG ; P = 0.61 and MCS (48.4 ± 10.7 in YG vs. 50.1 ± 6.9 in EG; P = 0.54). Conclusions In conclusion, laparoscopic total fundoplication is a safe and effective surgical treatment for gastroesophageal reflux disease generally warranting low morbidity and mortality rates and a significant improvement of symptoms comparable. An improved long-term quality of life is warranted even in the elderly.
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Brusciano L, Limongelli P, del Genio G, Di Stazio C, Rossetti G, Sansone S, Tolone S, Lucido F, D'Alessandro A, Docimo G, Docimo L. Short-term outcomes after rehabilitation treatment in patients selected by a novel rehabilitation score system (Brusciano score) with or without previous stapled transanal rectal resection (STARR) for rectal outlet obstruction. Int J Colorectal Dis 2013; 28:783-93. [PMID: 22983757 DOI: 10.1007/s00384-012-1565-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [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] [Accepted: 08/14/2012] [Indexed: 02/04/2023]
Abstract
PURPOSE The purpose of this study was to examine short-term outcomes of rehabilitation treatment in patients with or without previous stapled transanal resection (STARR) for rectal outlet obstruction by using a novel rehabilitation score system (Brusciano score). METHODS This is a retrospective cohort study conducted at a single tertiary referral institution including all patients with chronic functional constipation admitted to the outpatient unit from 2004 to 2009. RESULTS Among 330 consecutive patients, 247 (74.8 %) (204 females and 43 males) showing a significantly higher rehabilitation score (mean of 15.7 ± 1.8; range, 7-25) than healthy controls (mean, 3.2 ± 1.2; range 2-6) (p < .0001) were selected for rehabilitation. Of the 247 patients evaluated, group A (no previous surgery) consisted of 170 patients (53 males; mean age, 44.8 ± 12.9 years; range, 19-80) of which 38 presented mixed constipation, whereas group B (previous surgery) consisted of 77 patients (18 males; mean age, 47.0 ± 11.2 years; range, 22-81). The Brusciano score, Agachan-Wexner score and quality of life improved in both groups of patients after treatment. Better improvements of Brusciano and Agachan-Wexner scores were observed in patients with previous STARR (group B). CONCLUSIONS The rehabilitation score system employed in this study seems to be a useful tool in selecting and assessing the outcome of patients who might benefit from rehabilitation treatment. Constipation and quality of life were significantly improved by the rehabilitation treatment. Further studies are needed to clarify either the impact of rehabilitation treatment on long-term outcome of patients treated for rectal outlet obstruction or its role in those who develop problems over time.
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Affiliation(s)
- L Brusciano
- XI Division of General and Obesity Surgery, Second University of Naples, Naples, Italy.
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25
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D'Alessandro A, Mirasole C, Zolla L. Haemoglobin glycation (Hb1Ac) increases during red blood cell storage: a MALDI-TOF mass-spectrometry-based investigation. Vox Sang 2013; 105:177-80. [PMID: 23521396 DOI: 10.1111/vox.12029] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [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: 10/26/2012] [Revised: 01/10/2013] [Accepted: 01/18/2013] [Indexed: 12/01/2022]
Abstract
Haemoglobin A1c (HbA1c ) represents a key biomarker in diabetes diagnosis and management, as it is indicative of recent blood glucose concentrations. Glycation of haemoglobin is a non-enzymatic irreversible process that is promoted by the prolonged exposure of erythrocytes to high glucose concentrations, a condition that is known to occur under blood banking conditions. However, controversial data indicate no clear hint as to whether and to which extent HbA1c accumulates during red blood cell storage. Hereby, we propose the application of a validated MALDI-TOF mass-spectrometry-based method to this issue and report the observation about HbA1c levels apparently increasing over storage progression.
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Affiliation(s)
- A D'Alessandro
- Department of Ecological and Biological Sciences, University of Tuscia, Largo dell'Università, snc, Viterbo, Italy
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Docimo G, Tolone S, Pasquali D, Conzo G, D'Alessandro A, Casalino G, Gili S, Brusciano L, Gubitosi A, Del Genio G, Ruggiero R, Docimo L. Role of pre and post-operative oral calcium and vitamin D supplements in prevention of hypocalcemia after total thyroidectomy. G Chir 2012; 33:374-378. [PMID: 23140919] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
AIM to evaluate the role of pre and post-operative oral calcium and vitamin D supplements in prevention of hypocalcemia after total thyroidectomy. PATIENTS AND METHODS 50 consecutive patients, undergoing total thyroidectomy, were enrolled. Oral calcium and vitamin D were administered in the pre and post-operative time. The data concerning symptomatic and laboratoristic hypocalcemia were collected. RESULTS Incidence of symptomatic hypocalcemia was very low (6%); incidence of laboratoristic hypocalcemia was 10%. No permanent hypocalcemia developed. CONCLUSIONS Implementing oral calcium and vitamin D both before and after total thyroidectomy can reduce the incidence of hypocalcemia related to surgery.
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Affiliation(s)
- G Docimo
- Second University of Napoli, Napoli, Italy
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Festuccia C, Gravina G, Mancini A, D'Alessandro A, Chin L, Shechter S, Sandanayaka V, McCauley D, Kauffman M, Shacham S. 974 Selective Inhibitors of Nuclear Export (SINE) CRM1 (XPO1) Antagonists Activate Multiple Tumor Suppressor Pathways and Kill Prostate Cancer (PrCa) Cells. Eur J Cancer 2012. [DOI: 10.1016/s0959-8049(12)71592-7] [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: 11/30/2022]
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Abstract
AIM In this study, we performed weekly assessment of morphology-related parameters through monitoring of CPD-SAGM leuco-filtered erythrocyte concentrates from blood withdrawal until the 42nd day of storage. BACKGROUND Liquid storage of red blood cells (RBCs) delivers a blood-derived therapeutic, which is safe, available, effective and affordable for most patients who need transfusion therapy in developed countries. However, a growing body of accumulating controversial evidences, from either biochemical or retrospective clinical studies, prompted safety concerns about longer stored RBCs. METHODS Statistical image analysis through scanning electron microscope was coupled to osmotic fragility and erythrocyte sedimentation rate. RESULTS We could observe that by day 21 more than 50% of RBCs displayed non-discocyte phenotypes. This observation was related to an increase in osmotic fragility, which was totally overlapped in day 0 controls and day 7 RBCs while only slightly augmented in day 14 samples. Cation dysregulation (pH internal/external alteration and potassium) might both reflect and trigger a negative feedback loop with metabolic fluxes and membrane cation pumps. CONCLUSION Morphology parameters suggest that significant alterations to RBC morphology over storage duration occur soon after the 14th day of storage, as to become significant enough within the 21st day.
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Affiliation(s)
- B Blasi
- Department of Ecological and Biological Sciences, Tuscia University, Largo dell'Universitá snc, Viterbo, Italy
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Cuomo R, D'Alessandro A, Andreozzi P, Vozzella L, Sarnelli G. Gastrointestinal regulation of food intake: do gut motility, enteric nerves and entero-hormones play together? MINERVA ENDOCRINOL 2011; 36:281-293. [PMID: 22322652] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The gastrointestinal system can be considered the gateway for food entry in our body. Rather than being a passive player, it is now clear that gut strongly influence the feeding behavior and contribute to maintain energy balance with different signals. The aim of this review is to summarize the current knowledge about the role of gastrointestinal tract in the control of food intake, by focusing on the interplay existing between the enteric nervous system and gastrointestinal hormones and their ability to modulate digestive motility and sensitivity. Also the latest advances about the contribution of gut microbiota and gastrointestinal taste receptors are described. From the reported data it clearly emerges that gut hormones together with nervous signals likely contribute to the regulation of energy balance and modulate food intake through the control of digestive motility and sensations. The close linkage among gastrointestinal hormones, the gut and the central nervous systems appears very intriguing and has induced the development of a new field of research: the gastroendocrinology.
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Affiliation(s)
- R Cuomo
- Department of Clinical and Experimental Medicine, University of Naples Federico II, Naples, Italy.
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Fourati Ben Mustapha S, Khrouf M, Kacem Ben Rejeb K, Elloumi Chaabene H, Merdassi G, Wahbi D, Ben Meftah M, Zhioua F, Zhioua A, Azzarello A, Host T, Mikkelsen AL, Theofanakis CP, Dinopoulou V, Mavrogianni D, Partsinevelos GA, Drakakis P, Stefanidis K, Bletsa A, Loutradis D, Rienzi L, Cobo A, Paffoni A, Scarduelli C, Capalbo A, Garrido N, Remohi J, Ragni G, Ubaldi FM, Herrer R, Quera M, GIL E, Serna J, Grondahl ML, Bogstad J, Agerholm IE, Lemmen JG, Bentin-Ley U, Lundstrom P, Kesmodel US, Raaschou-Jensen M, Ladelund S, Guzman L, Ortega C, Albuz FK, Gilchrist RB, Devroey P, Smitz J, De Vos M, Bielanska M, Leveille MC, Borghi E, Magli MC, Figueroa MJ, Mascaretti G, Ferraretti AP, Gianaroli L, Szlit E, Leocata Nieto F, Maggiotto G, Arenas G, Tarducci Bonfiglio N, Ahumada A, Asch R, Sciorio R, Dayoub N, Thong J, Pickering S, Ten J, Carracedo MA, Guerrero J, Rodriguez-Arnedo A, Llacer J, Bernabeu R, Tatone C, Heizenrieder T, Di Emidio G, Treffon P, Seidel T, Eichenlaub-Ritter U, Cortezzi SS, Cabral EC, Ferreira CR, Trevisan MG, Figueira RCS, Braga DPAF, Eberlin MN, Iaconelli Jr. A, Borges Jr. E, Zabala A, Pessino T, Blanco L, Rey Valzacchi G, Leocata F, Ahumada A, Vanden Meerschaut F, Heindryckx B, Qian C, Deforce D, Leybaert L, De Sutter P, De las Heras M, De Pablo JL, Navarro B, Agirregoikoa JA, Barrenetxea G, Cruz M, Perez-Cano I, Gadea B, Herrero J, Martinez M, Roldan M, Munoz M, Pellicer A, Meseguer M, Munoz M, Cruz M, Roldan M, Gadea B, Galindo N, Martinez M, Pellicer A, Meseguer M, Perez-Cano I, Scarselli F, Alviggi E, Colasante A, Minasi MG, Rubino P, Lobascio M, Ferrero S, Litwicka K, Varricchio MT, Giannini P, Piscitelli P, Franco G, Zavaglia D, Nagy ZP, Greco E, Urner F, Wirthner D, Murisier F, Mock P, Germond M, Amorocho Llanos B, Calderon G, Lopez D, Fernandez L, Nicolas M, Landeras J, Finn-Sell SL, Leandri R, Fleming TP, Macklon NS, Cheong YC, Eckert JJ, Lee JH, Jung YJ, Hwang HK, Kang A, An SJ, Jung JY, Kwon HC, Lee SJ, Palini S, Zolla L, De Stefani S, Scala V, D'Alessandro A, Polli V, Rocchi P, Tiezzi A, Pelosi E, Dusi L, Bulletti C, Fadini R, Lain M, Mignini Renzini M, Brambillasca F, Coticchio G, Merola M, Guglielmo MC, Dal Canto M, Figueira R, Setti AS, Braga DPAF, Iaconelli Jr. A, Borges Jr. E, Worrilow KC, Uzochukwu CD, Eid S, Le Gac S, Esteves TC, van Rossem F, van den Berg A, Boiani M, Kasapi E, Panagiotidis Y, Goudakou M, Papatheodorou A, Pasadaki T, Prapas N, Prapas Y, Panagiotidis Y, Kasapi E, Goudakou M, Papatheodorou A, Pasadaki T, Vanderzwalmen P, Prapas N, Prapas Y, Norasing S, Atchajaroensatit P, Tawiwong W, Thepmanee O, Saenlao S, Aojanepong J, Hunsajarupan P, Sajjachareonpong K, Punyatanasakchai P, Maneepalviratn S, Jetsawangsri U, Herrero J, Cruz M, Tejera A, Rubio I, Romero JL, Meseguer M, Nordhoff V, Schlatt S, Schuring AN, Kiesel L, Kliesch S, Azambuja R, Okada L, Lazzari V, Dorfman L, Michelon J, Badalotti M, Badalotti F, Petracco A, Schwarzer C, Esteves TC, Nordhoff V, Schlatt S, Boiani M, Versieren K, Heindryckx B, De Croo I, Lierman S, De Vos W, Van den Abbeel E, Gerris J, De Sutter P, Milacic I, Borogovac D, Veljkovic M, Arsic B, Jovic Bojovic D, Lekic D, Pavlovic D, Garalejic E, Guglielmo MC, Coticchio G, Albertini DF, Dal Canto M, Brambillasca F, Mignini Renzini M, De Ponti E, Fadini R, Sanges F, Talevi R, Capalbo A, Papini L, Mollo V, Ubaldi FM, Rienzi LF, Gualtieri R, Albuz FK, Guzman L, Orteg C, Gilchrist RB, Devroey P, De Vos M, Smitz J, Choi J, Lee H, Ku S, Kim S, Choi Y, Kim J, Moon S, Demilly E, Assou S, Moussaddykine S, Dechaud H, Hamamah S, Takisawa T, Doshida M, Hattori H, Nakamura Y, Kyoya T, Shibuya Y, Nakajo Y, Tasaka A, Toya M, Kyono K, Novo S, Penon O, Gomez R, Barrios L, Duch M, Santalo J, Esteve J, Nogues C, Plaza JA, Perez-Garcia L, Ibanez E, Chavez S, Loewke K, Behr B, Reijo Pera R, Huang S, Wang H, Soong Y, Chang C, Okimura T, Kuwayama M, Mori C, Morita M, Uchiyama K, Aono F, Kato K, Takehara Y, Kato O, Minasi M, Casciani V, Scarselli F, Rubino P, Colasante A, Arizzi L, Litwicka K, Ferrero S, Mencacci C, Piscitelli C, Giannini P, Cucinelli F, Tocci A, Nagy ZP, Greco E, Wydooghe E, Vandaele L, Dewulf J, Van den Abbeel E, De Sutter P, Van Soom A, Moon JH, Son WY, Mahfoudh A, Henderson S, Jin SG, Shalom-Paz E, Dahan M, Holzer H, Mahmoud K, Triki-Hmam C, Terras K, Zhioua F, Hfaiedh T, Ben Aribia MH, Otsubo H, Egashira A, Tanaka K, Matsuguma T, Murakami M, Murakami K, Otsuka M, Yoshioka N, Araki Y, Kuramoto T, Smit JG, Sterrenburg MD, Eijkemans MJC, Al-Inany HG, Youssef MAFM, Broekmans FJM, Willoughby K, DiPaolo L, Deys L, Lagunov A, Amin S, Faghih M, Hughes E, Karnis M, Ashkar F, King WA, Neal MS, Antonova I, Veleva L, Petkova L, Shterev A, Nogales C, Martinez E, Ariza M, Cernuda D, Gaytan M, Linan A, Guillen A, Bronet F, Cottin V, Fabian D, Allemann F, Koller A, Spira JC, Agudo D, Martinez-Burgos M, Arnanz A, Basile N, Rodriguez A, Bronet F, Cho YS, Filioli Uranio M, Ambruosi B, Paternoster MS, Totaro P, Sardanelli AM, Dell'Aquila ME, Zollner U, Hofmann T, Zollner KP, Kovacic B, Roglic P, Vlaisavljevic V, Sole M, Santalo J, Boada M, Coroleu B, Veiga A, Martiny G, Molinari M, Revelli A, Chimote NM, Chimote M, Mehta B, Chimote NN, Sheikh N, Nath N, Mukherjee A, Rakic K, Reljic M, Kovacic B, Vlaisavljevic V, Ingerslev HJ, Kirkegaard K, Hindkjaer J, Grondahl ML, Kesmodel US, Agerholm I, Kitasaka H, Fukunaga N, Nagai R, Yoshimura T, Tamura F, Kitamura K, Hasegawa N, Nakayama K, Katou M, Itoi F, Asano E, Deguchi N, Ooyama K, Hashiba Y, Asada Y, Michaeli M, Rotfarb N, Karchovsky E, Ruzov O, Atamny R, Slush K, Fainaru O, Ellenbogen A, Chekuri S, Chaisrisawatsuk T, Chen P, Pangestu M, Jansen S, Catt S, Molinari E, Racca C, Revelli A, Ryu C, Kang S, Lee J, Chung D, Roh S, Chi H, Yokota Y, Yokota M, Yokota H, Sato S, Nakagawa M, Komatsubara M, Makita M, Araki Y, Yoshimura T, Asada Y, Fukunaga N, Nagai R, Kitasaka H, Itoi F, Tamura F, Kitamura K, Hasegawa N, Katou M, Nakayama K, Asano E, Deguchi N, Oyama K, Hashiba Y, Naruse K, Kilani S, Chapman MG, Kwik M, Chapman M, Guven S, Odaci E, Yildirim O, Kart C, Unsal MA, Yulug E, Isachenko E, Maettner R, Strehler E, Isachenko V, Hancke K, Kreienberg R, Sterzik K, Coticchio G, Guglielmo MC, Dal Canto M, Albertini DF, Brambillasca F, Mignini Renzini M, Fadini R, Zheng XY, Wang LN, Liu P, Qiao J, Inoue F, Dashtizad M, Wahid H, Rosnina Y, Daliri M, Hajarian H, Akbarpour M, Abbas Mazni O, Knez K, Tomaevic T, Vrtacnik Bokal E, Zorn B, Virant Klun I, Koster M, Liebenthron J, Nicolov A, van der Ven K, van der Ven H, Montag M, Fayazi M, Salehnia M, Beigi Boroujeni M, Khansarinejad B, Deignan K, Emerson G, Mocanu E, Wang JJ, Andonov M, Linara E, Ahuja KK, Nachef S, Figueira RCS, Braga DPAF, Setti AS, Iaconelli Jr. A, Pasqualotto FF, Borges Jr. E, Pasqualotto E, Borges Jr. E, Pasqualotto FF, Chang CC, Bernal DP, Elliott TA, Shapiro DB, Toledo AA, Nagy ZP, Economou K, Davies S, Argyrou M, Doriza S, Sisi P, Moschopoulou M, Karagianni A, Mendorou C, Polidoropoulos N, Papanicopoulos C, Stefanis P, Karamalegos C, Cazlaris H, Koutsilieris M, Mastrominas M, Gotts S, Doshi A, Harper J, Serhal P, Borini A, Guzeloglu-Kayisli O, Bianchi V, Seli E, Bianchi V, Lappi M, Bonu MA, Borini A, Mizuta S, Hashimoto H, Kuroda Y, Matsumoto Y, Mizusawa Y, Ogata S, Yamada S, Kokeguchi S, Noda Y, Shiotani M, Stojkovic M, Ilic M, Markovic N, Stojkovic P, Feng G, Zhang B, Zhou H, Zhou L, Gan X, Qin X, Shu J, Wu F, Molina Botella I, Lazaro Ibanez E, Debon Aucejo A, Pertusa J, Fernandez Colom PJ, Pellicer A, Li C, Zhang Y, Cui Y, Zhao H, Liu J, Oliveira JBA, Petersen CG, Mauri AL, Massaro FC, Silva LFI, Ricci J, Cavagna M, Pontes A, Vagnini LD, Baruffi RLR, Franco Jr. JG, Massaro FC, Petersen CG, Vagnini LD, Mauri AL, Silva LFI, Felipe V, Cavagna M, Pontes A, Baruffi RLR, Oliveira JBA, Franco Jr. JG, Vilela M, Tiveron M, Lombardi C, Viglierchio MI, Marconi G, Rawe V, Wale PL, Gardner DK, Nakagawa K, Sugiyama R, Nishi Y, Kuribayashi Y, Jyuen H, Yamashiro E, Shirai A, Sugiyama R, Inoue M, Salehnia M, Hovatta O, Tohonen V, Inzunza J, Parmegiani L, Cognigni GE, Bernardi S, Ciampaglia W, Infante FE, Tabarelli de Fatis C, Pocognoli P, Arnone A, Maccarini AM, Troilo E, Filicori M, Radwan P, Polac I, Borowiecka M, Bijak M, Radwan M. POSTER VIEWING SESSION - EMBRYOLOGY. Hum Reprod 2011. [DOI: 10.1093/humrep/26.s1.79] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Bruno M, Lambo R, Tommasi S, Luccarelli G, Broussard C, D'Alessandro A, Nenna C, Paradiso A, Pisconti S. 73 CANCER AT OTHER SITES THAN BREAST AND OVARY IN FAMILIES WITH OR WITHOUT BRCA1/2 GENES MUTATION. Cancer Treat Rev 2010. [DOI: 10.1016/s0305-7372(10)70099-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Reich DJ, Mulligan DC, Abt PL, Pruett TL, Abecassis MMI, D'Alessandro A, Pomfret EA, Freeman RB, Markmann JF, Hanto DW, Matas AJ, Roberts JP, Merion RM, Klintmalm GBG. ASTS recommended practice guidelines for controlled donation after cardiac death organ procurement and transplantation. Am J Transplant 2009; 9:2004-11. [PMID: 19624569 DOI: 10.1111/j.1600-6143.2009.02739.x] [Citation(s) in RCA: 253] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The American Society of Transplant Surgeons (ASTS) champions efforts to increase organ donation. Controlled donation after cardiac death (DCD) offers the family and the patient with a hopeless prognosis the option to donate when brain death criteria will not be met. Although DCD is increasing, this endeavor is still in the midst of development. DCD protocols, recovery techniques and organ acceptance criteria vary among organ procurement organizations and transplant centers. Growing enthusiasm for DCD has been tempered by the decreased yield of transplantable organs and less favorable posttransplant outcomes compared with donation after brain death. Logistics and ethics relevant to DCD engender discussion and debate among lay and medical communities. Regulatory oversight of the mandate to increase DCD and a recent lawsuit involving professional behavior during an attempted DCD have fueled scrutiny of this activity. Within this setting, the ASTS Council sought best-practice guidelines for controlled DCD organ donation and transplantation. The proposed guidelines are evidence based when possible. They cover many aspects of DCD kidney, liver and pancreas transplantation, including donor characteristics, consent, withdrawal of ventilatory support, operative technique, ischemia times, machine perfusion, recipient considerations and biliary issues. DCD organ transplantation involves unique challenges that these recommendations seek to address.
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Affiliation(s)
- D J Reich
- Drexel University College of Medicine, Philadelphia, PA, USA.
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Pizza F, Rossetti G, Del Genio G, Maffettone V, Napolitano V, Allaria A, Brusciano L, Montesarchio L, Tolone S, Di Martino M, Lucido FS, Barra L, Giugliano S, D'Alessandro A, Del Genio F, Pizza NL, Del Genio A. [Laparoscopic total fundoplication is not an obstacle to oesophageal emptying after oesophago-gastric myotomy for the surgical treatment of achalasia]. Chir Ital 2008; 60:803-811. [PMID: 19256270] [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: 05/27/2023]
Abstract
There are different surgical possibilities for the treatment of oesophageal achalasia ranging from a short extramucosal oesophagomyotomy to an extended esophago-gastric myotomy combined with a partial fundoplication to restore the main antireflux barrier. A total 360 degrees fundoplication is generally regarded as an obstacle to oesophageal emptying. The aim of this study was to evaluate the role and efficacy of total 360 degrees laparoscopic Nissen-Rossetti fundoplication after oesophago gastric myotomy in the treatment of oesophageal achalasia. From 1992 to January 2008, a total of 245 patients (112 males, 133 females), mean age 45.1 years (range: 12-79), were submitted to laparoscopic Nissen-Rossetti fundoplication after a Heller myotomy with endoscopic and manometric intraoperative monitoring. In 3 patients (1.2%), conversion to laparotomy was necessary. Mean operative time was 60 +/- 15 minutes. No mortality was observed. The overall morbidity rate was 1.6%. The mean postoperative hospital stay was 3.5 +/- 1.0 days (range: 1-12 days). A mean clinical follow-up of 100.2 +/- 7 months (range: 3-177) was possible for 228 patients (93.1%), and an excellent or good outcome was observed in 209 patients (91.7%) (DeMeester dysphagia score 0-1). No improvement in dysphagia was observed in 5 (2.2%) patients. Pathological gastro-oesophageal reflux was absent in all patients. Laparoscopic Nissen-Rossetti fundoplication after a Heller myotomy is a safe, effective treatment for oesophageal achalasia with excellent results in terms of dysphagia resolution, affording total protection from the onset of gastrooesophageal reflux.
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Affiliation(s)
- Francesco Pizza
- I Divisione di Chirurgia Generale e Gastrointestinale, Seconda Università di Napoli, Napoli
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Mazzei F, D'Alessandro A, Lucarelli F, Nava S, Prati P, Valli G, Vecchi R. Characterization of particulate matter sources in an urban environment. Sci Total Environ 2008; 401:81-9. [PMID: 18486189 DOI: 10.1016/j.scitotenv.2008.03.008] [Citation(s) in RCA: 99] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2007] [Revised: 03/04/2008] [Accepted: 03/06/2008] [Indexed: 05/15/2023]
Abstract
Daily time series measurements of elements or compounds are widely used to apportion the contribution of specific sources of particulate matter concentration in the atmosphere. We present results obtained for the urban area of Genoa (Italy) based on several hundred of PM10, PM2.5 and PM1 daily samples collected in sites with different geo-morphological and urbanization characteristics. Elemental concentrations of Na to Pb were obtained through Energy Dispersive X-Ray Fluorescence (ED-XRF), and the contributions of specific sources of particulate matter (PM) concentration were apportioned through Positive Matrix Factorization (PMF). By sampling at different sites we were able to obtain, in each PM fraction, the average and stable values for the tracers of specific sources, in particular traffic (Cu, Zn, Pb) and heavy oil combustion (V, Ni). We could also identify and quote the contamination of anthropogenic PM in "natural" sources (sea, soil dust). Sampling at several sites in the same urban area allowed us to resolve local characteristics as well as to quote average values.
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Affiliation(s)
- F Mazzei
- Dipartimento di Fisica and INFN, via Dodecaneso 33, 16146 Genova, Italy.
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Thomas ME, Rasweiler Iv JJ, D'Alessandro A. Experimental transmission of the parasitic flagellates Trypanosoma cruzi and Trypanosoma rangeli between triatomine bugs or mice and captive neotropical bats. Mem Inst Oswaldo Cruz 2008; 102:559-65. [PMID: 17710299 DOI: 10.1590/s0074-02762007005000068] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.9] [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: 11/09/2006] [Accepted: 05/28/2007] [Indexed: 11/22/2022] Open
Abstract
Trypanosoma cruzi and Trypanosoma rangeli-like trypanosomes have been found in a variety of neotropical bat species. In this study, bats (Artibeus lituratus, Carollia perspicillata, Desmodus rotundus, Glossophaga soricina, Molossus molossus, Phyllostomus hastatus) were maintained under controlled conditions, and experiments were conducted to determine how they might become infected naturally with trypanosomes. All bats were first screened for existing infections by hemoculture and the examination of blood smears, and only apparently uninfected animals were then used in the experiments. Proof was obtained that the triatomine bug Rhodnius prolixus would readily feed upon some of the bats, and two species became infected after being bitten by bugs infected with T. rangeli. Some bats also became infected by ingesting R. prolixus carrying T. cruzi, or following subcutaneous or intragastic inoculation with fecal suspensions of R. prolixus containing T. cruzi. P. hastatus became infected after ingesting mice carrying T. cruzi. All of the bats studied inhabit roosts that may be occupied by triatomine bugs and, with the exception of D. rotundus, all also feed to at least some extent upon insects. These findings provide further evidence of how bats may play significant roles in the epidemiology of T. cruzi and T. rangeli in the New World tropics.
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Affiliation(s)
- Maurice E Thomas
- Department of Obstetrics and Gynecology, Downstate Medical Center, State University of New York, Brooklyn, NY 11203, USA.
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Marenco F, Bonasoni P, Calzolari F, Ceriani M, Chiari M, Cristofanelli P, D'Alessandro A, Fermo P, Lucarelli F, Mazzei F, Nava S, Piazzalunga A, Prati P, Valli G, Vecchi R. Characterization of atmospheric aerosols at Monte Cimone, Italy, during summer 2004: Source apportionment and transport mechanisms. ACTA ACUST UNITED AC 2006. [DOI: 10.1029/2006jd007145] [Citation(s) in RCA: 94] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Baldan A, Marino D, DE Giorgio M, Angonese C, Cillo U, D'Alessandro A, Masotto A, Massani M, Mazzucco M, Miola E, Neri D, Paccagnella D, Pivetta G, Stellato A, Tommasi L, Tremolada F, Tufano A, Zanus G, Farinati F. Percutaneous radiofrequency thermal ablation for hepatocellular carcinoma. Aliment Pharmacol Ther 2006; 24:1495-501. [PMID: 17081166 DOI: 10.1111/j.1365-2036.2006.03136.x] [Citation(s) in RCA: 8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Radiofrequency thermal ablation is the first therapeutic option in percutaneous treatment of hepatocellular carcinoma but data on its long-term efficacy and safety are not conclusive. AIM This study reports a prospective survey on radiofrequency thermal ablation in north-east Italy. METHODS Data were collected on 401 patients with hepatocellular carcinoma (males 301, mean age: 68 years) treated by radiofrequency thermal ablation in 13 centres. Indication to treatment was: single nodule not eligible for surgery in 77% of patients, 2-3 nodes in 18% and multiple lesions in 5%. Mean size was 3 cm (1-8 cm). Treatment response was assessed at 1 month by spiral computerized tomography and then with ultrasound examination and new spiral computerized tomography. RESULTS Complete response was obtained in 67% of patients and in 27% response was 75-99%. Complete response raised to 77% in lesions smaller than 3 cm. The morbidity rate was 34%; the mortality was 0.5%, seeding was observed in four patients. Ten patients presented an unexpected rapid disease progression. CONCLUSION The above data show that by radiofrequency thermal ablation, complete response can be achieved only in about two-third of the cases, clearly less than expected, and that, beyond seeding, unexpected progression can be observed.
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Affiliation(s)
- A Baldan
- Dipartimento di Scienze Chirurgiche e Gastroenterologiche, Università di Padova, Padova, Italy
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Hammwöhner M, D'Alessandro A, Dobrev D, Kirchhof P, Goette A. [New antiarrhythmic drugs for therapy of atrial fibrillation: II. Non-ion channel blockers]. Herzschrittmacherther Elektrophysiol 2006; 17:73-80. [PMID: 16786465 DOI: 10.1007/s00399-006-0513-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [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: 04/06/2006] [Accepted: 05/04/2006] [Indexed: 05/10/2023]
Abstract
The therapeutic approach to atrial fibrillation is difficult and challenging. The effect of "classical" antiarrhythmic agents is based on their inhibitory effects on various ion channels. However, therapeutic benefit of these agents is often limited. The primary goal of this article is to discuss new therapeutic approaches using non-ion channel blocking drugs in the treatment of atrial fibrillation. Some of the substances discussed in this article have been used already in the clinical practice. Others, for example gentherapeutic approaches, are still in the experimental state. In contrast to ion channel blocking agents their efficacy is based on the suppression of structural remodeling. Hence, it can be assumed that due to these effects they may also be beneficial in the primary prevention of atrial fibrillation.
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Affiliation(s)
- M Hammwöhner
- Otto-von-Guericke Universitätsklinik Magdeburg, Klinik für Kardiologie, Angiologie und Pneumologie, Leipzigerstr. 44, 39120, Magdeburg, Germany
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Angonese C, Baldan A, Cillo U, D'Alessandro A, De Antoni M, De Giorgio M, Masotto A, Marino D, Massani M, Mazzucco M, Miola E, Neri D, Paccagnella D, Pivetta G, Tommasi L, Tremolada F, Tufano A, Zanus G, Farinati F. Complications of radiofrequency thermal ablation in hepatocellular carcinoma: what about "explosive" spread? Gut 2006; 55:435-6. [PMID: 16474113 PMCID: PMC1856082 DOI: 10.1136/gut.2005.080515] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/08/2022]
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40
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Ariola V, D'Alessandro A, Lucarelli F, Marcazzan G, Mazzei F, Nava S, Garcia-Orellana I, Prati P, Valli G, Vecchi R, Zucchiatti A. Elemental characterization of PM10, PM2.5 and PM1 in the town of Genoa (Italy). Chemosphere 2006; 62:226-32. [PMID: 15982708 DOI: 10.1016/j.chemosphere.2005.05.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2004] [Revised: 05/09/2005] [Accepted: 05/10/2005] [Indexed: 05/03/2023]
Abstract
The particulate matter (PM) concentration and composition, the PM10, PM2.5, PM1 fractions, were studied in the urban area of Genoa, a coastal town in the northwest of Italy. Two instruments, the continuous monitor TEOM and the sequential sampler PARTISOL, were operated almost continuously on the same site from July 2001 to September 2004. Samples collected by PARTISOL were weighted to obtain PM concentration and then analysed by PIXE (particle induced X-ray emission) and by ED-XRF (energy dispersion X-ray fluorescence), obtaining concentrations for elements from Na to Pb. Some of the filters used in the TEOM microbalance were analysed by ED-XRF to calculate Pb concentration values averaged over 7-30 d periods.
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Affiliation(s)
- V Ariola
- Dipartimento di Fisica and INFN, Universita degli Studi di Genova, via Dodecaneso 33, I-16146 Genova, Italy
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41
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Iannuzzi L, Perucatti A, Di Meo GP, Polimeno F, Ciotola F, Incarnato D, Peretti V, Caputi-Jambrenghi A, Pecoraro A, Manniti F, D'Alessandro A, Vonghia G. Chromosome fragility in two sheep flocks exposed to dioxins during pasturage. Mutagenesis 2005; 19:355-9. [PMID: 15388807 DOI: 10.1093/mutage/geh041] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
In the last 3 years several farms raising cattle, river buffalo and sheep have been unable to sell dairy milk due to the presence of high levels of dioxins. Furthermore, several cases of abortion (around 25% of total births) and abnormal foetuses (2.5% of total births) were recorded in two flocks of sheep raised in the province of Naples where a higher level of dioxins (5.27 pg/g fat, as human WHO TCDD equivalent) have been found in the milk mass than that permitted (3.0 pg/g fat, as human WHO TCDD equivalent). Cytogenetic investigations were carried out on 24 sheep (all females), randomly sampled from the two different flocks, one abnormal foetus and 11 female sheep (control) raised approximately 80 km from the area where the two exposed flocks were raised. Frequencies of aneuploid cells, gaps, chromatid breaks, chromosome breaks, fragments and sister chromatid exchange (SCE) were determined. While no differences were observed between the number of aneuploid cells (15% of total cell population) of both exposed animals and controls, significant (P < 0.001) increases in the frequencies of other chromosome abnormalities (mean chromosome abnormality/cell = 0.76 +/- 1.1) and SCEs (mean SCE/cell = 9.4 +/- 3.7) were found in the exposed animals, compared with the control (mean chromosome abnormality/cell = 0.18 +/- 0.4; mean SCE/cell = 7.1 +/- 3.0). Significantly higher values of SCEs (mean SCE/cell = 10.9 +/- 4.4) were also found in the abnormal foetus compared with the control. Chemical analyses on soil, grass and water at two sites where the two flocks were pastured established that doses of dioxins (17 different types) were below the legally permitted limits.
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Affiliation(s)
- L Iannuzzi
- National Research Council (CNR), ISPAAM, Laboratory of Animal Cytogenetics and Gene Mapping, Via Argine 1085, 80147 Naples, Italy.
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Abstract
Two cases of submandibular echinococcosis have been reported in adult residents of India (Kini et al., 1997; Sahni et al., 2000). It was stated in both publications that the cestode was E. oligarthrus, "a rare variety of E. granulosus", based on morphogical characteristics. It was also mentioned that 3 cases of E. granulosus with similar submandibular metacestode had been previously diagnosed in India. The metacestode is readily distinguishable from that of E. oligarthrus. The final hosts of E. oligarthrus are several neotropical species of wild cats and metacestode occurs in hystricognath, all of them absent in India. The larval stage of all 4 species of Echinococcus can be differentiated on the basis of the form and dimensions of rostellar hooks of protoescoleces. With the information provided in the two papers we concluded that the 2 cases of echinococcosis described in India were due to E. granulosus.
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Affiliation(s)
- A D'Alessandro
- Department of Tropical Medicine, Tulane University, 1440 Canal Street, New Orleans, Louisiana 70112, USA.
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43
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D'Alessandro A, Folletti I, Muzi G, Murgia N, Brugnami G, Abritti G. [Use of sputum in the follow-up of hypersensitivity pneumonia]. G Ital Med Lav Ergon 2003; 25 Suppl:284-5. [PMID: 14979187] [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] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Affiliation(s)
- A D'Alessandro
- Istituto di Medicina del Lavoro Università degli Studi di Perugia
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44
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Tassone P, Tagliaferri P, Viscomi C, Palmieri C, Caraglia M, D'Alessandro A, Galea E, Goel A, Abbruzzese A, Boland CR, Venuta S. Zoledronic acid induces antiproliferative and apoptotic effects in human pancreatic cancer cells in vitro. Br J Cancer 2003; 88:1971-8. [PMID: 12799645 PMCID: PMC2741108 DOI: 10.1038/sj.bjc.6600986] [Citation(s) in RCA: 122] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Bisphosphonates (BPs) are an emerging class of drugs mostly used in the palliative care of cancer patients. We investigated the in vitro activity of the most potent antiresorptive BP, zoledronic acid (ZOL), on the growth and survival of three human pancreatic cancer (PC) cell lines (BxPC-3, CFPAC-1 and PANC-1). Pancreatic cancer frequently has a dysregulated p21(ras) pathway and therefore appears to be a suitable target for BPs that interfere with the prenylation of small GTP-binding proteins such as p21(ras). We found that ZOL induces growth inhibition (IC(50):10-50 micro M) and apoptotic death of PC cells. The proapoptotic effect was correlated to cleavage/activation of caspase-9 and poly(ADP)-ribose polymerase, but not of caspase-3. Moreover, we studied the p21(ras) signalling in cells exposed to ZOL and detected a reduction of p21(ras) and Raf-1 content and functional downregulation of the terminal enzyme ERK/MAPkinase and of the pKB/Akt survival pathway. Finally, we observed that ZOL induces significant cytoskeletal rearrangements. In conclusion, we demonstrated that ZOL induces growth inhibition and apoptosis on PC cells and interferes with growth and survival pathways downstream to p21(ras). These findings might be relevant for expanding application of BPs in cancer treatment.
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Affiliation(s)
- P Tassone
- Oncology Unit, Department of Experimental and Clinical Medicine, Via T. Campanella, 115 'Magna Graecia' University, 88100 Catanzaro, Italy.
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Raffaele A, Valenti M, Iovenitti M, Matani A, Bruno ML, Altobelli E, D'Alessandro A, Barnabei R, Leonardis B, Taglieri G. High prevalence of HCV infection among the general population in a rural area of central Italy. Eur J Epidemiol 2002; 17:41-6. [PMID: 11523574 DOI: 10.1023/a:1010932832190] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The hepatitis C virus infection (HCV) is the most frequent cause of hepatic infection in Europe. In Italy, anti-HCV positivity values are extremely variable, depending on the age and geographic location of the population being analysed. The aims of the study were: (1) evaluating positivity for anti-HCV antibodies in various age groups and determining the HBsAg in a mountainous and predominantly farming area in central Italy; (2) assessing some anamnestic and clinical variables through a questionnaire, submitted during the taking of blood samples, in order to determine HCV exposure and risk factors for the target population. 344 subjects selected by random sampling among 3308 people, older than 16, were considered as the target population. A prevalence study was carried out. The sources of data were: blood samples taken to carry out the HCV positivity test; a questionnaire including items about exposures at risk and case-historical and clinical patient data. The risk of infection was evaluated by a multiple logistic regression model. The inferred HCV+ prevalence rate is 22.4/100 (95% confidence interval (CI): 20.8-24.1). An increasing age trend is shown with a higher positive predominance among females (28.99/100 vs. 14.29/100 in males). The positive HBsAg prevalence in the examined survey is 1.2/100. Variables associated with the HCV occurrence are case history of pneumonopathy (OR: 4.9) and exposure to parenteral therapies with glass syringes (OR: 3.3). This study is consistent with literature about the hypothesis of a north-south geographic gradient in the hepatitis C occurrence in Italy. Data clearly show the effects of the inappropriate use of medical or surgery practices on the population, with particular reference to the use of glass syringes. No elements prove that the farming features of the area may be predictive of HCV infection risk. The extent of the recorded prevalence values calls for the implementation of programmes aimed at detecting clusters or population areas at risk.
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Affiliation(s)
- A Raffaele
- Department of Internal Medicine and Public Health, University of L'Aquila, Italy
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D'Alessandro A, Benowitz NL, Muzi G, Eisner MD, Filiberto S, Fantozzi P, Montanari L, Abbritti G. Systemic nicotine exposure in tobacco harvesters. Arch Environ Health 2001; 56:257-63. [PMID: 11480503 DOI: 10.1080/00039890109604451] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Several epidemics of nicotine intoxication have been described among tobacco harvesters; however, little is known about nicotine absorption under typical working conditions. To assess systemic nicotine absorption during a regular working shift, the authors performed an observational field study. Included in the study were 10 healthy, nonsmoking, female tobacco harvesters and a control group of 5 healthy, nonsmoking, female hospital workers. Nicotine and cotinine were measured in sequential samples of blood and urine during a regular workshift. Blood nicotine levels rose from a nadir value of 0.79 +/- 0.12 ng/ml to a peak value of 3.45 +/- 0.84 ng/ml (p < .05 [Tukey's modified t test]) in the exposed group. In the control group, levels were stable at 0.1 +/- 0.1 ng/ml (p < .01). Moreover, the mean blood nicotine level measured 3 mo following the end of exposure in 6 of 10 exposed subjects was 0.24 +/- 0.12 ng/ml (p < .01). Corresponding higher values of urine nicotine and urine cotinine were observed in the exposed versus control group (comparative p values were < .01 and < .05, respectively). Overall, tobacco harvesters absorbed approximately 0.8 mg of nicotine daily. Given that nicotine can induce adverse health effects, the authors believe that prevention of nicotine absorption in tobacco harvesters should be sought and that workers should be informed about occupational risks.
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Affiliation(s)
- A D'Alessandro
- Dipartimento di Medicina Clinica e Sperimentale-Istituto di Medicina del Lavoro Università di Perugia, Italy
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Baroni T, Bodo M, D'Alessandro A, Conte C, Calvitti M, Muzi G, Lumare A, Bellocchio S, Abbritti G. Silica and its antagonistic effects on transforming growth factor-beta in lung fibroblast extracellular matrix production. J Investig Med 2001; 49:146-56. [PMID: 11288755 DOI: 10.2310/6650.2001.34041] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Silicosis, a pneumoconiosis marked by interstitial pulmonary fibrosis, is caused by inhalation of free crystalline silica particles. When silica particles are injected into the lower lung, they are translocated across the epithelium into the interstitial space, where macrophage-derived growth factors affect lung fibroblast proliferation and collagen deposition. We hypothesized that silica may act directly on pulmonary fibroblasts modifying extracellular matrix (ECM) synthesis and that the effects of silica may be mediated by transforming growth factor-beta (TGFbeta) overproduction. METHODS To test this hypothesis, we studied a human lung fibroblast cell line (WI-1003) exposed to silica in vitro. We investigated cell morphology by electron microscopic procedure, cell growth, collagen production, and glycosaminoglycans (GAG) composition by radiolabeled precursors. Cytokine and growth factor synthesis were evaluated by specific enzyme-linked immunoadsorbent assay kits and Northern blotting analysis. RESULTS Pulmonary fibroblasts internalized silica particles without detectable cell damage. Silica directly stimulated collagen synthesis and decreased the amount of 3H-glucosamine-labeled GAG. Silica-treated fibroblasts secreted less TGFbeta than untreated controls, antagonized the stimulatory effect of TGFbeta on ECM synthesis, and reversed TGFbeta-induced inhibition of cell proliferation. Northern blotting analysis showed increased interleukin-1alpha (IL-1alpha) mRNA after silica treatment. IL-1alpha had no influence on collagen synthesis but increased the number of WI-1003 fibroblasts. CONCLUSIONS These results support our hypothesis that lung fibroblasts are direct silica targets. However, contradicting our hypothesis, silica antagonized TGFbeta activities through a TGFbeta downregulation and an IL-1alpha upregulation. The complex pattern of TGFbeta and IL-1alpha regulation in pulmonary fibroblasts is imbalanced by silica exposure and might play a key role in silica-mediated pulmonary fibrosis.
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Affiliation(s)
- T Baroni
- Histology Section, Faculty of Medicine, University of Perugia, Italy
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Odorico JS, Pirsch JD, Becker YT, Knechtle SJ, D'Alessandro A, Werwinski C, Sollinger HW. Results of solitary pancreas transplantation with enteric drainage: is there a benefit from monitoring urinary amylase levels? Transplant Proc 2001; 33:1700. [PMID: 11267476 DOI: 10.1016/s0041-1345(00)02648-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- J S Odorico
- Department of Surgery, University of Wisconsin-Madison, Madison, Wisconsin, USA
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Bodo M, Baroni T, Bellocchio S, Calvitti M, Lilli C, D'Alessandro A, Muzi G, Lumare A, Abbritti G. Bronchial epithelial cell matrix production in response to silica and basic fibroblast growth factor. Mol Med 2001; 7:83-92. [PMID: 11471549 PMCID: PMC1950019] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023] Open
Abstract
BACKGROUND Previous studies show that macrophages, lung fibroblasts, and their soluble mediators are responsible for the onset and development of pulmonary fibrosis. This study was conducted to determine whether airway epithelial cells are also directly involved in response to fibrogenic agents and consequently in the pathogenesis of lung fibrosis. To verify the hypothesis, we determined whether silica acts directly on human bronchial epithelial cells by stimulating cytokine and growth factor release and by modifying matrix production. MATERIALS AND METHODS An SV40 large T antigen-transformed human airway epithelial cell line, 16HBE14o (16HBE), was used. The expression profile of some proinflammatory interleukins (ILs), such as IL-1alpha, IL-1beta and IL-6 and their modulation by silica, were evaluated by polymerase chain reaction (PCR) analysis. Transforming growth factor beta (TGFbeta) and basic fibroblast growth factor (bFGF) mRNA levels were tested by Northern blotting in the presence and in the absence of silica. The silica- and/or bFGF-induced effects on matrix components (total proteins, collagen, and fibronectin) were also evaluated using radio-labeled precursors. RESULTS The results demonstrated 16HBE internalized silica particles. Silica induced a little IL-6 secretion, without affecting IL-1 and TGFbeta isoform production and strongly stimulated bFGF mRNA level and bFGF protein secretion. Silica also induced changes in 16HBE production of total proteins, collagen, and fibronectin production. When added in combination with the growth factor, it strengthened bFGF stimulation of matrix component secretion. CONCLUSIONS These results support the hypothesis that the changes in matrix components are due to a direct effect of silica on bronchial epithelial cells. Silica-induced over-secretion of bFGF suggests that autocrine and paracrine differentiation loops for bFGF may also be operative and that these mechanisms may be involved in the pathogenesis of pulmonary fibrosis. In the future, cytokine-directed therapeutic strategies might find a place in clinical practice.
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Affiliation(s)
- M Bodo
- Histology Section, Faculty of Medicine, University of Perugia, Italy.
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50
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Abstract
Yellow nail syndrome is characterized by primary lymphoedema, recurrent pleural effusion and yellow discoloration of the nails. Although mechanical lymphatic obstruction is assumed to be the underlying pathology, it cannot explain the common finding of high albumin concentration in the pleural space. This paper describes a case of yellow nail syndrome presenting with the classical triad of lymphoedema, recurrent pleural effusion and yellow discoloration of the nails, associated with persistent hypoalbuminaemia and increased enteric loss of albumin. Based on the findings in this case and those in the literature, it is speculated that increased microvascular permeability may contribute to the pathogenesis of this syndrome.
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Affiliation(s)
- A D'Alessandro
- Dipartimento di Medicina Clinica E Sperimentale, Università degli studi di Perugia, Italy
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