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Bada Bosch I, De Palacio A, Fernández Bautista B, Ordóñez J, Ortiz R, Burgos L, Parente A, Angulo JM. Endourological treatment of ectopic ureterocele. Our experience in the last 15 years. Cir Pediatr 2023; 36:78-82. [PMID: 37093117 DOI: 10.54847/cp.2023.02.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
Abstract
OBJECTIVE To assess the efficacy of the endourological treatment of ectopic ureterocele in children in a large series and with a long-term follow-up. MATERIALS AND METHODS A retrospective, descriptive study of patients with ectopic ureterocele who had undergone surgery in our institution in the last 15 years was carried out. All patients were treated using an endourological approach, both for ureterocele and postoperative vesicoureteral reflux (VUR). RESULTS 40 patients were treated -55% with left involvement and 5% with bilateral involvement. Mean age at diagnosis was 4.97 months, with diagnosis being established prenatally in 54.1% of cases. In all patients but one, endourological puncture of the ureterocele was conducted. Mean age at surgery was 6.96 months (0-1.11). Surgery was performed on an outpatient basis in 94.9% of patients. No perioperative complications were recorded. In the last 30 patients, preoperative voiding cystourethrography was not carried out. 72.5% of patients had postoperative VUR (44.8% into the upper pyelon, 10.3% into the lower pyelon, 17.2% into both, 6.9% into the contralateral system, and 20.7% into the bilateral system), but it was resolved with a single endoscopic procedure in 48.1% of cases (65% of patients were healed with two procedures). VUR was not endoscopically resolved in 3 patients who required ureteral re-implantation. 6 patients required heminephrectomy (n=3) or nephrectomy (n=3) as a result of functional impairment and infections. CONCLUSION The endourological treatment of ectopic ureterocele is a little aggressive and little invasive technique that allows the obstruction to be resolved on an outpatient basis, which means bladder surgery -if required- can be performed outside the neonatal period.
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Affiliation(s)
- I Bada Bosch
- Pediatric Surgery Department. Hospital General Universitario Gregorio Marañón. Madrid (Spain)
| | - A De Palacio
- Urology Department. Hospital Central de la Defensa Gómez Ulla. Madrid (Spain)
| | - B Fernández Bautista
- Pediatric Surgery Department. Hospital General Universitario Gregorio Marañón. Madrid (Spain)
| | - J Ordóñez
- Pediatric Surgery Department. Hospital General Universitario Gregorio Marañón. Madrid (Spain)
| | - R Ortiz
- Pediatric Surgery Department. Hospital General Universitario Gregorio Marañón. Madrid (Spain)
| | - L Burgos
- Pediatric Surgery Department. Hospital General Universitario Gregorio Marañón. Madrid (Spain)
| | - A Parente
- Pediatric Surgery Department. Hospital Universitario Reina Sofía. Córdoba (Spain)
| | - J M Angulo
- Pediatric Surgery Department. Hospital General Universitario Gregorio Marañón. Madrid (Spain)
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Parente A, Navarro H, Vargas NM, Lapa P, Basaran AC, González EM, Redondo C, Morales R, Munoz Noval A, Schuller IK, Vicent JL. Unusual Magnetic Hysteresis and Transition between Vortex and Double Pole States Arising from Interlayer Coupling in Diamond-Shaped Nanostructures. ACS Appl Mater Interfaces 2022; 14:54961-54968. [PMID: 36469495 DOI: 10.1021/acsami.2c16950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Controlling the magnetic ground states at the nanoscale is a long-standing basic research problem and an important issue in magnetic storage technologies. Here, we designed a nanostructured material that exhibits very unusual hysteresis loops due to a transition between vortex and double pole states. Arrays of 700 nm diamond-shaped nanodots consisting of Py(30 nm)/Ru(tRu)/Py(30 nm) (Py, permalloy (Ni80Fe20)) trilayers were fabricated by interference lithography and e-beam evaporation. We show that varying the Ru interlayer spacer thickness (tRu) governs the interaction between the Py layers. We found this interaction mainly mediated by two mechanisms: magnetostatic interaction that favors antiparallel (antiferromagnetic, AFM) alignment of the Py layers and exchange interaction that oscillates between ferromagnetic (FM) and AFM couplings. For a certain range of Ru thicknesses, FM coupling dominates and forms magnetic vortices in the upper and lower Py layers. For Ru thicknesses at which AFM coupling dominates, the magnetic state in remanence is a double pole structure. Our results showed that the interlayer exchange coupling interaction remains finite even at 4 nm Ru thickness. The magnetic states in remanence, observed by magnetic force microscopy (MFM), are in good agreement with corresponding hysteresis loops obtained by the magneto-optic Kerr effect (MOKE) and micromagnetic simulations.
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Affiliation(s)
- A Parente
- Departamento de Física de Materiales, Facultad de Física, Universidad Complutense de Madrid, Pl. Ciencias, 1, 28040 Madrid, Spain
| | - H Navarro
- Department of Physics and Center for Advanced Nanoscience, University of California San Diego, La Jolla, California 92093, United States
| | - N M Vargas
- Department of Physics and Center for Advanced Nanoscience, University of California San Diego, La Jolla, California 92093, United States
| | - P Lapa
- Department of Physics and Center for Advanced Nanoscience, University of California San Diego, La Jolla, California 92093, United States
| | - Ali C Basaran
- Department of Physics and Center for Advanced Nanoscience, University of California San Diego, La Jolla, California 92093, United States
| | - E M González
- Departamento de Física de Materiales, Facultad de Física, Universidad Complutense de Madrid, Pl. Ciencias, 1, 28040 Madrid, Spain
- IMDEA Nanociencia, c/ Faraday, 9, 28049 Madrid, Spain
| | - C Redondo
- Department of Physical Chemistry, University of the Basque Country UPV/EHU, 48940 Leioa, Spain
| | - R Morales
- Department of Physical Chemistry, University of the Basque Country UPV/EHU & BCMaterials, 48940 Leioa, Spain
- IKERBASQUE. Basque Foundation for Science, 48009 Bilbao, Spain
| | - A Munoz Noval
- Departamento de Física de Materiales, Facultad de Física, Universidad Complutense de Madrid, Pl. Ciencias, 1, 28040 Madrid, Spain
- IMDEA Nanociencia, c/ Faraday, 9, 28049 Madrid, Spain
| | - Ivan K Schuller
- Department of Physics and Center for Advanced Nanoscience, University of California San Diego, La Jolla, California 92093, United States
| | - J L Vicent
- Departamento de Física de Materiales, Facultad de Física, Universidad Complutense de Madrid, Pl. Ciencias, 1, 28040 Madrid, Spain
- IMDEA Nanociencia, c/ Faraday, 9, 28049 Madrid, Spain
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Infantino R, Boccella S, Scuteri D, Perrone M, Ricciardi F, Vitale R, Bonsale R, Parente A, Allocca I, Virtuoso A, De Luca C, Belardo C, Amodeo P, Gentile V, Cirillo G, Bagetta G, Luongo L, Maione S, Guida F. 2-pentadecyl-2-oxazoline prevents cognitive and social behaviour impairments in the Amyloid β-induced Alzheimer-like mice model: Bring the α2 adrenergic receptor back into play. Biomed Pharmacother 2022; 156:113844. [DOI: 10.1016/j.biopha.2022.113844] [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] [Received: 09/12/2022] [Revised: 10/03/2022] [Accepted: 10/06/2022] [Indexed: 11/15/2022] Open
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Tipler S, D’Alessio G, Van Haute Q, Parente A, Contino F, Coussement A. Predicting octane numbers relying on principal component analysis and artificial neural network. Comput Chem Eng 2022. [DOI: 10.1016/j.compchemeng.2022.107784] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Bianco M, Parente A, Biolè C, Righetti C, Spirito A, Luciano A, Destefanis P, Nangeroni G, Angusti T, Anselmino M, Montagna L. The prevalence of TTR cardiac amyloidosis among patients undergoing bone scintigraphy. J Nucl Cardiol 2021; 28:825-830. [PMID: 33728572 DOI: 10.1007/s12350-021-02575-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 02/09/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Radiolabeled bisphosphonates bone scintigraphy is highly sensitive in detecting transthyretin (TTR) cardiac amyloidosis; data on the true prevalence of cardiac involvement in TTR amyloidosis are lacking. METHODS AND RESULTS This retrospective observational, monocentric study aims to estimate the prevalence of positive bone scan suspect for TTR cardiac amyloidosis among an all-comers population who underwent a bone scintigraphy. ECG, echocardiography and clinical status of patients with unexpected cardiac uptake (Perugini score 2-3) who underwent bone scintigraphy with [99mTc]-HDP or [99mTc]-DPD at San Luigi Gonzaga University Hospital between January 2015 and May 2020 have been collected. The prevalence of bone scintigraphy suspect for cardiac involvement was 0.54% (23/4,228). The bone scintigraphy was mainly performed using [99mTc]-HDP (82.9%) and the dominant indication for the test was oncology in the 47.9% of cases. 8 Subjects had a history of neuropathy (34.8%) and 5 of carpal tunnel syndrome (21.7%). 11 Patients suffered a previous episode of heart failure (48%) while 5 patients (21.7%) were totally asymptomatic, without any sign or symptom before the bone scintigraphy making the nuclear examination crucial for an early diagnosis of TTR amyloidosis. CONCLUSION Bone scintigraphy allows suspecting TTR amyloidosis in a pre-clinical stage of the disease in an all-comers population of patients undergoing bone scintigraphy mainly for oncology reasons.
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Affiliation(s)
- Matteo Bianco
- Division of Cardiology, San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy.
| | - A Parente
- Division of Nuclear Medicine, San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy
| | - C Biolè
- Division of Cardiology, San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy
| | - C Righetti
- Division of Cardiology, San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy
| | - A Spirito
- Division of Cardiology, San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy
| | - A Luciano
- Division of Cardiology, San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy
| | - P Destefanis
- Division of Cardiology, San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy
| | - G Nangeroni
- Division of Cardiology, San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy
| | - T Angusti
- Division of Nuclear Medicine, San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy
| | - M Anselmino
- Division of Cardiology, Department of Medical Sciences, Città della Salute e della Scienza di Torino" Hospital, University of Turin, Turin, Italy
| | - L Montagna
- Division of Cardiology, San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy
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Shore ND, Guerrero S, Sanahuja RM, Gambús G, Parente A. A New Sustained-release, 3-Month Leuprolide Acetate Formulation Achieves and Maintains Castrate Concentrations of Testosterone in Patients With Prostate Cancer. Clin Ther 2019; 41:412-425. [DOI: 10.1016/j.clinthera.2019.01.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 01/09/2019] [Accepted: 01/09/2019] [Indexed: 10/27/2022]
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8
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Sforza D, Iaria G, Petagna L, Parente A, Anselmo A, Sergi F, Marzio S, Corrado F, Telli S, Manzia TM, Tisone G. Switch From Twice-daily Tacrolimus to Once-daily, Prolonged-release Tacrolimus in Kidney Transplantation: Long-term Outcome. Transplant Proc 2018; 51:140-142. [PMID: 30655129 DOI: 10.1016/j.transproceed.2018.04.079] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 04/13/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND One daily dose of tacrolimus (QDT) improves adherence in kidney transplant (KT) recipients. A switch from twice-daily tacrolimus (BDT) to QDT showed similar efficacy and safety. METHODS The aim of our study was to demonstrate the long-term efficacy and safety of switching from BDT to QDT in KT recipients. Preliminary results have already been published. Forty-one patients (34 men and 7 women), mean age at KT of 43.9 ± 12.7 years, underwent a 1:1 dose switch from BDT to QDT; the mean time from KT to switch was 36.6 ± 16.1 months. In our study population, 4 patients received a living donor KT and 2 received a second allograft. RESULTS The mean follow-up was 86.8 ± 13 months from the switch and 126.2 ± 22.3 months from KT. Graft and patient survival rates were 90.2% and 95.1%, respectively. All patients maintained stable renal function during follow-up. During the first 3 months after the switch we observed a significant decrease in tacrolimus blood level (P = .0001). No significant differences were observed regarding tacrolimus dose before and after QDT introduction (P = not significant [NS]). Fourteen patients who stopped steroids under BDT treatment and 16 patients who stopped steroids after the switch are currently steroid-free. CONCLUSION Our study showed safety and efficacy in switching from BDT to QDT. After early (<1 year) dose adjustment, tacrolimus blood levels remained stable throughout follow-up. Moreover, QDT represented a valid alternative for patients showing steroid side effects.
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Affiliation(s)
- D Sforza
- Hepatobiliary and Transplant Unit, Department of Surgery, Tor Vergata University, Rome, Italy.
| | - G Iaria
- Hepatobiliary and Transplant Unit, Department of Surgery, Tor Vergata University, Rome, Italy
| | - L Petagna
- Hepatobiliary and Transplant Unit, Department of Surgery, Tor Vergata University, Rome, Italy
| | - A Parente
- Hepatobiliary and Transplant Unit, Department of Surgery, Tor Vergata University, Rome, Italy
| | - A Anselmo
- Hepatobiliary and Transplant Unit, Department of Surgery, Tor Vergata University, Rome, Italy
| | - F Sergi
- Hepatobiliary and Transplant Unit, Department of Surgery, Tor Vergata University, Rome, Italy
| | - S Marzio
- Hepatobiliary and Transplant Unit, Department of Surgery, Tor Vergata University, Rome, Italy
| | - F Corrado
- Hepatobiliary and Transplant Unit, Department of Surgery, Tor Vergata University, Rome, Italy
| | - S Telli
- Hepatobiliary and Transplant Unit, Department of Surgery, Tor Vergata University, Rome, Italy
| | - T M Manzia
- Hepatobiliary and Transplant Unit, Department of Surgery, Tor Vergata University, Rome, Italy
| | - G Tisone
- Hepatobiliary and Transplant Unit, Department of Surgery, Tor Vergata University, Rome, Italy
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D'Amore C, Marsico F, Parente A, Paolillo S, De Martino F, Gargiulo P, Ferrazzano F, De Roberto AM, La Mura L, Marciano C, Dellegrottaglie S, Trimarco B, Perrone Filardi P. Vitamin D deficiency and clinical outcome in patients with chronic heart failure: A review. Nutr Metab Cardiovasc Dis 2017; 27:837-849. [PMID: 28954706 DOI: 10.1016/j.numecd.2017.07.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Revised: 07/17/2017] [Accepted: 07/23/2017] [Indexed: 12/26/2022]
Abstract
AIM The aim of this review was to summarize evidence on the role of Vitamin D deficiency in heart failure (HF), from pathophysiological mechanisms to clinical effects of Vitamin D supplementation. DATA SYNTHESIS Chronic HF secondary to left ventricular (LV) systolic dysfunction is a growing health problem, still associated with poor clinical outcome. In recent years, experimental and epidemiological evidence focused on the role of Vitamin D in HF. Cross sectional studies demonstrated that prevalence of HF is increased in patients with Vitamin D deficiency or parathyroid hormone (PTH) plasma level increase, whereas longitudinal studies showed enhanced risk of developing new HF in patients with Vitamin D deficiency. In addition, in patients with established HF, low plasma levels of Vitamin D are associated with worsening clinical outcome. Yet, clinical studies did not definitively demonstrate a benefit of Vitamin D supplementation for preventing HF or ameliorating clinical outcome in patients with established HF. CONCLUSIONS Despite convincing experimental and epidemiological data, treatment with Vitamin D supplementation did not show clear evidence of benefit for preventing HF or influencing its clinical course. Ongoing clinical studies will hopefully shed lights on the effects of Vitamin D supplementation on clinical endpoints along the spectrum of HF.
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Affiliation(s)
| | - F Marsico
- Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy
| | - A Parente
- Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy
| | | | - F De Martino
- Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy
| | | | - F Ferrazzano
- Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy
| | - A M De Roberto
- Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy
| | - L La Mura
- Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy
| | - C Marciano
- Istituto Diagnostico Varelli, Naples, Italy
| | | | - B Trimarco
- Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy
| | - P Perrone Filardi
- Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy.
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Marsico F, D'Andrea C, Parente A, De Martino F, Capasso L, Raimondi F, Paolillo S, Dellegrottaglie S, Marciano C, Trimarco B, Perrone Filardi P. Hypertrophic cardiomyopathy in mitochondrial disorders: description of an uncommon clinical case. Eur J Heart Fail 2017; 19:1201-1204. [DOI: 10.1002/ejhf.858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Revised: 03/25/2017] [Accepted: 03/28/2017] [Indexed: 11/08/2022] Open
Affiliation(s)
- Fabio Marsico
- Department of Advanced Biomedical Sciences; University of Naples Federico II; Naples Italy
| | - Claudia D'Andrea
- Department of Advanced Biomedical Sciences; University of Naples Federico II; Naples Italy
| | - Antonio Parente
- Department of Advanced Biomedical Sciences; University of Naples Federico II; Naples Italy
| | - Fabiana De Martino
- Department of Advanced Biomedical Sciences; University of Naples Federico II; Naples Italy
| | - Letizia Capasso
- Department of Translational Medical Sciences; University of Naples Federico II; Naples Italy
| | - Francesco Raimondi
- Department of Translational Medical Sciences; University of Naples Federico II; Naples Italy
| | | | | | | | - Bruno Trimarco
- Department of Advanced Biomedical Sciences; University of Naples Federico II; Naples Italy
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Simal I, Parente A, Burgos L, Ortiz R, Martínez AB, Rojo R, Pérez-Egido L, Angulo JM. Therapeutic possibilities for urolithiasis in childhood. Actas Urol Esp 2016; 40:577-584. [PMID: 27289139 DOI: 10.1016/j.acuro.2016.03.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Revised: 03/18/2016] [Accepted: 03/28/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVES We present our case studies on paediatric urolithiasis, the techniques employed in its treatment and its results. MATERIAL AND METHODS A retrospective study of paediatric urolithiasis of the upper urinary tract (UUT) treated at our centre between 2003 and 2014. We recorded demographic, clinical, diagnostic and therapeutic data and the complications. The therapeutic plan was recorded as isolated (extracorporeal lithotripsy, ureterorenoscopy, nephrolithotomy or surgery) or combined therapy. RESULTS We examined 41 renal/urethral units in 32 patients. The median age was 5 years (range, 11 months-14 years). The mean size was 12.9cm (±7.3mm). The locations were as follows: 23 (56%) in the renal pelvis (staghorn in 15 cases), 10 (24) in lower calyx and 8 (20%) in the urethra. We performed 80 procedures, with no differences in the age groups, which resulted in 12 complications (15%) but no septic condition secondary to lithotripsy. Stone removal from the urethra had a 100% success rate with the ureterorenoscopy. The overall cure rate was 90%. CONCLUSION The paediatric urolithiasis approach offers multiple alternatives. It is therefore important to tailor the procedure according to the size, location and composition of the stone. In our centre, the use of paediatric extracorporeal shock wave lithotripsy is safer. Ureterorenoscopy, semirigid or flexible, provides excellent results in ureters. Percutaneous nephrolithotomy with minimal access can be performed on small children and nursing infants.
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Affiliation(s)
- I Simal
- Servicio de Cirugía Pediátrica, Sección de Urología Pediátrica, Hospital General Universitario Gregorio Marañón, Madrid, España.
| | - A Parente
- Servicio de Cirugía Pediátrica, Sección de Urología Pediátrica, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - L Burgos
- Servicio de Cirugía Pediátrica, Sección de Urología Pediátrica, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - R Ortiz
- Servicio de Cirugía Pediátrica, Sección de Urología Pediátrica, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - A B Martínez
- Servicio de Nefrología Pediátrica, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - R Rojo
- Servicio de Cirugía Pediátrica, Sección de Urología Pediátrica, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - L Pérez-Egido
- Servicio de Cirugía Pediátrica, Sección de Urología Pediátrica, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - J M Angulo
- Servicio de Cirugía Pediátrica, Sección de Urología Pediátrica, Hospital General Universitario Gregorio Marañón, Madrid, España
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Marsico F, Cecere M, Parente A, Paolillo S, de Martino F, Dellegrottaglie S, Trimarco B, Perrone Filardi P. Effects of novel oral anticoagulants on left atrial and left atrial appendage thrombi: an appraisal. J Thromb Thrombolysis 2016; 43:139-148. [DOI: 10.1007/s11239-016-1421-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Giovagnoli AR, Parente A, Didato G, Manfredi V, Deleo F, Tringali G, Villani F. The course of language functions after temporal lobe epilepsy surgery: a prospective study. Eur J Neurol 2016; 23:1713-1721. [PMID: 27529582 DOI: 10.1111/ene.13113] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2015] [Accepted: 06/08/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND PURPOSE Anterior temporal lobectomy (ATL) within the language-dominant hemisphere can impair naming. This prospective study examined the pre-operative to post-operative course of different language components, clarifying which changes are relevant within the short-term and long-term outcome of language. METHODS Patients with drug-resistant temporal lobe epilepsy (TLE) were evaluated using the Token, Boston Naming and Word Fluency tests assessing sentence comprehension and word-finding on visual, semantic or phonemic cues. RESULTS A total of 106 patients were evaluated before and 6 months, 1 and 2 years after ATL; 60 patients were also evaluated after 5 years and 38 controls were assessed at baseline. Seizure outcome was comparable between the left and right TLE patients. Before surgery, naming and word fluency were impaired in the left and right TLE patients, whereas sentence comprehension was normal. After left or right ATL, word fluency progressively improved, naming showed early worsening and late improvement after left ATL and progressive improvement after right ATL, and sentence comprehension did not change. At the 5-year follow-up, naming improvement was clinically significant in 31% and 71% of the left and right TLE patients, respectively. Pre-operative naming, ATL laterality, schooling, and post-operative seizure frequency and number of antiepileptic drugs predicted post-operative naming. Pre-operative word fluency and schooling predicted post-operative word fluency. CONCLUSIONS Left or right TLE can impair word-finding but not sentence comprehension. After ATL, word-finding may improve for a long time, depending on TLE laterality, seizure control and mental reserve. These findings may clarify prognosis prior to treatment.
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Affiliation(s)
- A R Giovagnoli
- Unit of Neurology and Neuropathology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - A Parente
- Unit of Neurology and Neuropathology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - G Didato
- Clinical Epileptology and Experimental Neurophysiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - V Manfredi
- Unit of Neurology and Neuropathology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - F Deleo
- Clinical Epileptology and Experimental Neurophysiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - G Tringali
- Neurosurgery III, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - F Villani
- Clinical Epileptology and Experimental Neurophysiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
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Scala O, Paolillo S, Formisano R, Pellegrino T, Rengo G, Gargiulo P, De Michele F, Starace A, Rapacciuolo A, Parisi V, Prastaro M, Piscopo V, Dellegrottaglie S, Bruzzese D, De Martino F, Parente A, Leosco D, Trimarco B, Cuocolo A, Perrone-Filardi P. Sleep-disordered breathing, impaired cardiac adrenergic innervation and prognosis in heart failure. Heart 2016; 102:1813-1819. [DOI: 10.1136/heartjnl-2015-309215] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 05/26/2016] [Accepted: 05/30/2016] [Indexed: 11/04/2022] Open
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Savarese G, Savonitto S, Lund LH, Paolillo S, Marciano C, Dellegrottaglie S, Parente A, Trimarco B, Luscher TF, Perrone-Filardi P. Efficacy and safety of prolonged dual antiplatelet therapy: a meta-analysis of 15 randomized trials enrolling 85 265 patients. Eur Heart J Cardiovasc Pharmacother 2016; 2:218-28. [DOI: 10.1093/ehjcvp/pvw011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Accepted: 04/17/2016] [Indexed: 11/12/2022]
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Gargiulo P, D’Amore C, Dellegrottaglie S, Leosco D, Rengo G, Musella F, Pirozzi E, Mosca S, Casaretti L, Formisano R, Bologna A, Parente A, Conte S, Perrone-Filardi P. From myocardium to the atherosclerotic plaque: new perspectives in cardiologic imaging. Monaldi Arch Chest Dis 2015; 76:60-5. [DOI: 10.4081/monaldi.2011.190] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Molecular imaging is an innovative and promising approach in cardiology for functional characterization of atherosclerosis. Nuclear, ultrasound and magnetic resonance imaging have been used for assessment of atherosclerosis of large and small arteries in several clinical and experimental studies. Positron Emission Tomography with fluorodeoxyglucose can measure metabolic activity and vulnerability of atherosclerotic plaques, identifying individuals at risk of future cardiovascular events. Magnetic resonance imaging can quantify carotid artery inflammation using iron oxide nanoparticles as contrast agent. In addition, macrophage accumulation of iron particles in atherosclerotic plaques may allow monitoring of inflammation during drug therapy, whereas contrast-enhanced ultrasound imaging may detect plaque neovascularization. Currently, technical factors, including cardiac and diaphragmatic motion and small size of coronary vessels, limit routine application of these techniques for coronary imaging. Purpose of this review is to describe state of the art and potential areas of clinical applications of molecular imaging of atherosclerosis.
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Zornoza M, Angulo JM, Parente A, Simal S, Burgos L, Ortiz R. Late diagnosis of posterior urethral valves. Actas Urol Esp 2015; 39:646-50. [PMID: 26112258 DOI: 10.1016/j.acuro.2015.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 05/04/2015] [Revised: 05/17/2015] [Accepted: 05/18/2015] [Indexed: 11/28/2022]
Abstract
CLINICAL PROBLEM We diagnosed 8 patients with late-stage posterior urethral valves (PUV) between 1 and 14 years of age. Five patients complained of symptoms related to voiding dysfunction. The other 3 patients required urethrocystoscopy for other reasons (hypospadias fistulae, difficulty with catheterisation and high-grade vesicoureteral reflux [VUR]). A second review of the first 2 patients' medical history showed voiding dysfunction symptoms. All patients underwent preoperative ultrasonography: 3 patients had normal results and 5 had renal or vesical disorders. The diagnosis was reached through voiding cystourethrogram (VCUG), and 4 patients underwent urodynamic studies. The diagnosis was confirmed by urethrocystoscopy, performing valve electrofulguration. We performed urethrocystoscopy during the check-ups at 3-6 weeks and observed no stenosis. The symptoms disappeared for all patients after 20 months of follow-up. The patient with VUR was cured. The ultrasounds showed no progression of the renal involvement and showed improvement in the vesical involvement. The velocimetries during check-ups presented curves within normal ranges. DISCUSSION Most children with PUV are diagnosed through ultrasound during the neonatal period. Some patients present PUV at later ages with diverse symptoms, which impedes its diagnosis. We should suspect PUV in male patients with symptoms of voiding dysfunction, either when they have normal or pathological results from ultrasounds or VCUG. We recommend performing urethrocystoscopy to rule out urethral obstruction.
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Affiliation(s)
- M Zornoza
- Sección de Urología Pediátrica, Servicio de Cirugía Pediátrica, Hospital Infantil Gregorio Marañón, Madrid, España.
| | - J M Angulo
- Sección de Urología Pediátrica, Servicio de Cirugía Pediátrica, Hospital Infantil Gregorio Marañón, Madrid, España
| | - A Parente
- Sección de Urología Pediátrica, Servicio de Cirugía Pediátrica, Hospital Infantil Gregorio Marañón, Madrid, España
| | - S Simal
- Sección de Urología Pediátrica, Servicio de Cirugía Pediátrica, Hospital Infantil Gregorio Marañón, Madrid, España
| | - L Burgos
- Sección de Urología Pediátrica, Servicio de Cirugía Pediátrica, Hospital Infantil Gregorio Marañón, Madrid, España
| | - R Ortiz
- Sección de Urología Pediátrica, Servicio de Cirugía Pediátrica, Hospital Infantil Gregorio Marañón, Madrid, España
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Fanjul M, Pérez L, Cerdá J, Zornoza M, Rojo R, Simal I, García-Casillas MA, Corona C, Peláez D, Molina E, Parente A, Rivas S, Angulo JM, De Tomás E. [Fast track protocol for children undergoing appendicectomy]. Cir Pediatr 2015; 28:177-183. [PMID: 27775294] [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] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND Multiple approaches to the treatment of simple and complicated (gangrenous or perforated) appendicitis in children have been promoted. Our goal is to develop a new protocol for these patients that allows shorter hospital stays without increasing complications rates. METHODS Prospective collected data of patients undergoing appendicitis treated according to the new protocol for a period of 7 months were reviewed. This protocol consists on antibiotic prophylaxis in all cases continued with triple antibiotic regimen in complicated appendicitis. Antibiotics were stopped when specific clinical and laboratory criteria were met. Outcomes are compared to a historical group of patients treated under standard protocol (antibiotic prophylaxis followed by 48 hours of dual antibiotic therapy in simple appendicitis or 5 day-course of triple antibiotic therapy in complicated as postooperative antibiotic regimen). RESULTS A total of 196 patients (96 current group and 100 historical group) were reviewed. In simple appendicitis average length of postoperative hospitalization was significantly lower in the current group (no statistical difference). 52.9% of complicated appendicitis in the current group were discharged home before 5th day without increasing the complication rate. When a wound infection or intraabdominal abscess occurs thrombocytosis (52%) and prolonged vomiting are the most frequent symptoms. CONCLUSION No further postoperative treatment is needed in simple appendicitis. In complicated appendictis a short course of antibiotics according to clinical and laboratory criteria allows early discharge without major morbidity. Prolonged postoperative vomiting and thrombocytosis suggest infectious complications.
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Affiliation(s)
- M Fanjul
- Hospital General Universitario Gregorio Marañón. Madrid
| | - L Pérez
- Hospital General Universitario Gregorio Marañón. Madrid
| | - J Cerdá
- Hospital General Universitario Gregorio Marañón. Madrid
| | - M Zornoza
- Hospital General Universitario Gregorio Marañón. Madrid
| | - R Rojo
- Hospital General Universitario Gregorio Marañón. Madrid
| | - I Simal
- Hospital General Universitario Gregorio Marañón. Madrid
| | | | - C Corona
- Hospital General Universitario Gregorio Marañón. Madrid
| | - D Peláez
- Hospital General Universitario Gregorio Marañón. Madrid
| | - E Molina
- Hospital General Universitario Gregorio Marañón. Madrid
| | - A Parente
- Hospital General Universitario Gregorio Marañón. Madrid
| | - S Rivas
- Hospital General Universitario Gregorio Marañón. Madrid
| | - J M Angulo
- Hospital General Universitario Gregorio Marañón. Madrid
| | - E De Tomás
- Hospital General Universitario Gregorio Marañón. Madrid
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Parente A, Angulo J, Burgos L, Romero R, Rivas S, Ortiz R. Percutaneous Endopyelotomy over High Pressure Balloon for Recurrent Ureteropelvic Junction Obstruction in Children. J Urol 2015; 194:184-9. [DOI: 10.1016/j.juro.2015.01.074] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2015] [Indexed: 11/16/2022]
Affiliation(s)
- A. Parente
- Pediatric Urology Department, Gregorio Marañón University Hospital, Madrid, Spain
| | - J.M. Angulo
- Pediatric Urology Department, Gregorio Marañón University Hospital, Madrid, Spain
| | - L. Burgos
- Pediatric Urology Department, Gregorio Marañón University Hospital, Madrid, Spain
| | - R.M. Romero
- Pediatric Urology Department, Gregorio Marañón University Hospital, Madrid, Spain
| | - S. Rivas
- Pediatric Urology Department, Gregorio Marañón University Hospital, Madrid, Spain
| | - R. Ortiz
- Pediatric Urology Department, Gregorio Marañón University Hospital, Madrid, Spain
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Savarese G, Rosano GM, Parente A, D'Amore C, Reiner MF, Camici GG, Trimarco B, Perrone-Filardi P. Reduction of C-reactive protein is not associated with reduced cardiovascular risk and mortality in patients treated with statins. A meta-analysis of 22 randomized trials. Int J Cardiol 2014; 177:152-60. [DOI: 10.1016/j.ijcard.2014.09.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Revised: 07/30/2014] [Accepted: 09/16/2014] [Indexed: 12/26/2022]
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21
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Mosca S, Gargiulo P, Balato N, Di Costanzo L, Parente A, Paolillo S, Ayala F, Trimarco B, Crea F, Perrone-Filardi P. Ischemic cardiovascular involvement in psoriasis: a systematic review. Int J Cardiol 2014; 178:191-9. [PMID: 25464252 DOI: 10.1016/j.ijcard.2014.10.092] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Accepted: 10/21/2014] [Indexed: 12/14/2022]
Abstract
Epidemiologic studies demonstrate that psoriasis is associated with shorter life expectancy, most frequently attributable to cardiovascular (CV) events. Although increased prevalence and incidence of CV risk factors for atherosclerosis have been reported in psoriatic patients, psoriasis likely plays an independent role in the increased cardiovascular risk, presumably linked to the chronic systemic inflammatory state. Consistently, preliminary investigations suggest that anti-inflammatory therapies may improve early subclinical vascular alterations and reduce cardiovascular morbidity and mortality. This review will focus on ischemic CV involvement in psoriatic patients, summarizing the prevalence and incidence of CV risk factors and CV events, as well as evidence on mechanisms of premature atherosclerosis and on effects of systemic anti-inflammatory therapies on CV risk profile. We performed a systematic review using Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and evaluated the quality of studies comparing drug treatments using Detsky score. Our review documented that psoriatic patients are at increased CV risk, related to raised prevalence and incidence of CV risk factor and to inflammatory status. However, available literature lacks of studies that establish appropriate targets for CV risk factors and assess the clinical value of screening for subclinical organ damage and the impact of disease-modifying therapies on CV risk profile in psoriatic patients. Awareness of raised CV risk in psoriatic patients should foster further research aimed at elucidating these aspects.
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Affiliation(s)
- Susanna Mosca
- Department of Advanced Biomedical Sciences, Section of Cardiology, "Federico II" University, Naples, Italy
| | - Paola Gargiulo
- SDN Foundation, Institute of Diagnostic and Nuclear Development, Naples, Italy
| | - Nicola Balato
- Department of Clinical Medicine and Surgery, Section of Dermatology, "Federico II" University, Naples, Italy
| | - Luisa Di Costanzo
- Department of Clinical Medicine and Surgery, Section of Dermatology, "Federico II" University, Naples, Italy
| | - Antonio Parente
- Department of Advanced Biomedical Sciences, Section of Cardiology, "Federico II" University, Naples, Italy
| | - Stefania Paolillo
- Department of Advanced Biomedical Sciences, Section of Cardiology, "Federico II" University, Naples, Italy
| | - Fabio Ayala
- Department of Clinical Medicine and Surgery, Section of Dermatology, "Federico II" University, Naples, Italy
| | - Bruno Trimarco
- Department of Advanced Biomedical Sciences, Section of Cardiology, "Federico II" University, Naples, Italy
| | - Filippo Crea
- Department of Cardiovascular Medicine, Policlinico A. Gemelli, "Catholic University of the Sacred Heart", Rome, Italy
| | - Pasquale Perrone-Filardi
- Department of Advanced Biomedical Sciences, Section of Cardiology, "Federico II" University, Naples, Italy.
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Dello Monaco A, Nuzzi A, Parente A, Lavermicocca V, Chiarelli T, De Tommaso M, Fiore P, Megna M. I03 Swallowing Function In The Early, Middle And Late Stages Of Huntington's Disease. J Neurol Psychiatry 2014. [DOI: 10.1136/jnnp-2014-309032.165] [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: 11/04/2022]
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Marsico F, Giugliano G, Ruggiero D, Parente A, Paolillo S, Guercio LD, Esposito G, Trimarco B, Filardi PP. Prevalence and severity of asymptomatic coronary and carotid artery disease in patients with abdominal aortic aneurysm. Angiology 2014; 66:360-4. [PMID: 24965380 DOI: 10.1177/0003319714540319] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We evaluated the prevalence and severity of occult coronary artery disease (CAD) and cerebrovascular disease (CeVD) in patients with abdominal aortic aneurysm (AAA). We studied 100 consecutive patients with no history of CAD, normal electrocardiogram, normal systolic function, and no angina or dyspnea. All patients underwent carotid Doppler study and invasive coronary angiography. Significant CAD was observed in 61% of patients. In all, 51% of patients with significant CAD showed either left main (n = 7), 3-vessel (n = 17), or proximal left anterior descending (n = 7) CAD, corresponding to 31% of the total cohort. Cerebrovascular disease was detected in 53% of patients, and in 38% of them was significant (peak systolic flow velocity ≥125 <230 cm/s). In 36% of patients with CeVD either left main (n = 5), 3-vessel (n = 11), or proximal left anterior descending (n = 3) CAD was observed. Severe asymptomatic CAD is prevalent in AAA, and 31% of patients fulfill indications for coronary revascularization.
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Affiliation(s)
- Fabio Marsico
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Giuseppe Giugliano
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Donatella Ruggiero
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Antonio Parente
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Stefania Paolillo
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Luca Del Guercio
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Giovanni Esposito
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Bruno Trimarco
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
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Montesano F, Parente A, Grassi F, Santamaria P. POSIDONIA-BASED COMPOST AS A GROWING MEDIUM FOR THE SOILLESS CULTIVATION OF TOMATO. ACTA ACUST UNITED AC 2014. [DOI: 10.17660/actahortic.2014.1034.34] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Savarese G, Parente A, D'Amore C, Trimarco B, Perrone-Filardi P. REDUCTION OF C-REACTIVE PROTEIN IS ASSOCIATED WITH REDUCED RISK OF MYOCARDIAL INFARCTION: A META-ANALYSIS OF 16 RANDOMIZED TRIALS. J Am Coll Cardiol 2014. [DOI: 10.1016/s0735-1097(14)60250-3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Guida V, Ferrari G, Pataro G, Chambery A, Di Maro A, Parente A. The effects of ohmic and conventional blanching on the nutritional, bioactive compounds and quality parameters of artichoke heads. Lebensm Wiss Technol 2013. [DOI: 10.1016/j.lwt.2013.04.006] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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27
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Mosca S, Paolillo S, Colao A, Bossone E, Cittadini A, Iudice FL, Parente A, Conte S, Rengo G, Leosco D, Trimarco B, Filardi PP. Cardiovascular involvement in patients affected by acromegaly: An appraisal. Int J Cardiol 2013; 167:1712-8. [DOI: 10.1016/j.ijcard.2012.11.109] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2012] [Revised: 10/01/2012] [Accepted: 11/13/2012] [Indexed: 10/27/2022]
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Rosazza C, Ghielmetti F, Minati L, Vitali P, Giovagnoli A, Deleo F, Didato G, Parente A, Marras C, Bruzzone M, D'Incerti L, Spreafico R, Villani F. Preoperative language lateralization in temporal lobe epilepsy (TLE) predicts peri-ictal, pre- and post-operative language performance: An fMRI study. Neuroimage Clin 2013; 3:73-83. [PMID: 24179851 PMCID: PMC3807502 DOI: 10.1016/j.nicl.2013.07.001] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Revised: 05/31/2013] [Accepted: 07/01/2013] [Indexed: 11/15/2022]
Abstract
In patients with temporal lobe epilepsy (TLE), assessment of language lateralization is important as anterior temporal lobectomy may lead to language impairments. Despite the widespread use of fMRI, evidence of its usefulness in predicting postsurgical language performance is scant. We investigated whether preoperative functional lateralization is related to the preoperative language performance, peri-ictal aphasia, and can predict language outcome one year post-surgery. We studied a total of 72 TLE patients (42 left, 30 right), by using three fMRI tasks: Naming, Verb Generation and Fluency. Functional lateralization indices were analyzed with neuropsychological scores and presence of peri-ictal aphasia. The key findings are:1)Both left and right TLE patients show decreased left lateralization compared to controls.2)Lateralization correlates with language performance before surgery. In left TLE, decreased left lateralization correlates with better fluency performance. In right TLE, increased left lateralization during the Naming task correlates with better naming.3)Left lateralization correlates with peri-ictal aphasia in left TLE patients.4)Lateralization correlates with language performance after surgery. In a subgroup of left TLE who underwent surgery (17 left), decreased left lateralization is predictive of better naming performance at 6 and 12 months after surgery. The present study highlights the clinical relevance of fMRI language lateralization in TLE, especially to predict language outcome one year post-surgery. We also underline the importance of using fMRI tasks eliciting frontal and anterior temporal activations, when studying left and right TLE patients.
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Affiliation(s)
- C. Rosazza
- Neuroradiology Dept., Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Milano, Italy
- Scientific Dept., Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Milano, Italy
| | - F. Ghielmetti
- Neuroradiology Dept., Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Milano, Italy
- Health Dept., Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Milano, Italy
| | - L. Minati
- Scientific Dept., Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Milano, Italy
| | - P. Vitali
- Brain MRI 3T Mondino Research Center, Istituto Neurologico “C. Mondino”, Pavia, Italy
| | - A.R. Giovagnoli
- Neuropsychology Laboratory, Dept. of Clinical Neurosciences, Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Milano, Italy
| | - F. Deleo
- Division of Clinical Epileptology and Experimental Neurophysiology, Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Milano, Italy
| | - G. Didato
- Division of Clinical Epileptology and Experimental Neurophysiology, Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Milano, Italy
| | - A. Parente
- Neuropsychology Laboratory, Dept. of Clinical Neurosciences, Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Milano, Italy
| | - C. Marras
- Neurosurgery Dept., Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Milano, Italy
- Dept. of Neuroscience Bambino Gesù Children Hospital, Rome, Italy
| | - M.G. Bruzzone
- Neuroradiology Dept., Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Milano, Italy
| | - L. D'Incerti
- Neuroradiology Dept., Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Milano, Italy
| | - R. Spreafico
- Division of Clinical Epileptology and Experimental Neurophysiology, Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Milano, Italy
| | - F. Villani
- Division of Clinical Epileptology and Experimental Neurophysiology, Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Milano, Italy
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Marsico F, Parente A, Paolillo S, Casaretti L, Lo Iudice F, Pirozzi E, Conte S, Iardino E, Gambardella F, Della Ratta GL, Cirillo A, Vitagliano A, Filardi PP. [Cardiovascular risk in systemic inflammatory diseases]. G Ital Cardiol (Rome) 2013; 14:517-525. [PMID: 23877549 DOI: 10.1714/1308.14460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Systemic inflammatory diseases are associated with increased cardiovascular morbidity and mortality. The link between inflammatory and cardiovascular diseases can be attributed to the coexistence of classical risk factors and inflammatory mechanisms activated during systemic inflammatory diseases involving the immune system. Unfavorable metabolic effects of anti-inflammatory drugs can also contribute to increase cardiovascular risk. Yet, clinical implications of these findings are not entirely clear, and deeper knowledge and awareness of cardiac involvement in inflammatory diseases are necessary. The aim of this review is to summarize cardiac involvement in systemic inflammatory diseases and to identify aspects where evidence is currently lacking that would deserve further investigation in the future.
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Affiliation(s)
- Fabio Marsico
- Dipartimento di Scienze Biomediche Avanzate, Università degli Studi Federico II, Napoli, Italy
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Marsico F, Ruggiero D, Parente A, Pirozzi E, Musella F, Lo Iudice F, Savarese G, Losco T, Giugliano G, Rengo G, Dellegrottaglie S, Leosco D, Esposito G, Trimarco B, Perrone-Filardi P. Prevalence and severity of asymptomatic coronary and carotid artery disease in patients with lower limbs arterial disease. Atherosclerosis 2013; 228:386-9. [DOI: 10.1016/j.atherosclerosis.2013.03.025] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Revised: 02/28/2013] [Accepted: 03/18/2013] [Indexed: 01/07/2023]
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Parente A, Lima M, Januarioda Silvad C, Fernandes R, Lamas C. P66 DAPTOMYCIN USE IN INFECTIVE ENDOCARDITIS AT A CARDIAC SURGERY REFERRAL HOSPITAL, 20092012, RIO DE JANEIRO, BRAZIL. Int J Antimicrob Agents 2013. [DOI: 10.1016/s0924-8579(13)70090-6] [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: 10/26/2022]
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Tardáguila AR, Romero R, Parente A, Rivas S, Fanjul M, Corona C, Angulo JM. ["Fast-track" in pediatric urologic surgery: pronenephrectomy]. Cir Pediatr 2013; 26:81-85. [PMID: 24228358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
UNLABELLED INTRODUCTION AND OBJETIVES: Minimal invasive surgery trends to get prompt recovery in terms of inmediate deambulation and early discharge from hospital, without increasing patient's discomfort neither postoperative complications. This "fast-track" protocol is being progresively introduced in a crescent number of urological procedures. We are evaluating the viability of applying it in retroperitoneoscopic prone- position nephrectomy. METHODS AND MATERIALS We have performed a retrospective review of the clinical reports of the patients submitted to prone nephrectomy with hospitalization between 2007 and 2011 and we present patients submitted to this procedure in an outpatient basis (less than 8 hours hospital stay) from 2011. We have recorded epidemiological factors, diagnosis, surgical time, first postoperative week analgesic requirements, parents cofort and postoperative complications. RESULTS All the procedures were performed retroperitoneoscopically in prone position using two trocars. We included 34 nephrectomies with a mean surgical time of 107 minutes. Mean postoperative stay was under 24 hours in 23 patients, two of them were discharged in the first 8 hours after the procedure. Hospital stay over this time was due to concomitant pre-existent pathology in 6 patients and to non urological fever in the remaining 3. Analgesia was excellent in every patient with endovenous non-steroid drugs, registering no pain after administering them orally. There were no complications. CONCLUSIONS We believe that "fast-track" requirements can be applied to prone-retroperitoneoscopic nephrectomy in pediatric population, as long as they have no associated pathology. In our experience this surgical procedure can be included in day-case surgery, increasing patient's confort and with a positive economical impact.
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Affiliation(s)
- A R Tardáguila
- Sección de Urología Infantil, Servicio de Cirugía Pediátrica, Hospital Materno Infantil Gregorio Marañón, Madrid.
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Iudice FL, Galderisi M, Paolillo S, D'Amore C, Parente A, Savarese G, Marciano C, Fabiani I, Pellegrino AM, Casaretti L, Perrone-Filardi P. CORONARY MICROVASCULAR FUNCTION IS IMPAIRED IN HIGH-RISK PATIENTS WITH CHRONIC RENAL DYSFUNCTION AND NORMAL EPICARDIAL CORONARY ARTERIES: A TRANSTHORACIC ECHOCARDIOGRAPHIC DOPPLER STUDY. J Am Coll Cardiol 2013. [DOI: 10.1016/s0735-1097(13)60959-6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Rojo R, Fanjul M, García-Casillas MA, Corona C, Tardáguila AR, Zornoza M, Simal I, Cañizo A, Molina E, Peláez D, Angulo JM, Romero R, Rivas S, Parente A, de Tomás E, Cerdá JA. [Surgical wound infections in newborns: analysis of risk factors]. Cir Pediatr 2012; 25:129-134. [PMID: 23480008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
UNLABELLED The incidence of surgical wound infections in neonates is high and it has an associated morbidity which extends hospital stay and gets a worse prognosis. The purpose of this study is to analyze the risk factors associated with the development of surgical wound infection and to identify susceptible patients with modifiable factors. MATERIAL AND METHODS Case-control study of 90 surgical procedures underwent in newborns. We analyze pre-, intra- and postoperative risk factors. MAIN RESULTS There are statically significant differences in terms of wound infection in dirty and contaminated surgery, reoperation, lavage of abdominal cavity, preoperative hospital stay longer than 8 days and wound closure with reabsorbable material. Furthermore, the surgical site infection is more likely in preterms patients, with a previous positive culture infection and the use of invasive devices as mechanical ventilation or central venous access. We found no relationship between wound infection and surgical time, bleeding during surgery and preoperative skin preparation with antiseptics. CONCLUSIONS Reoperative patients, in which dirty and contaminated surgery is performed, absorbable material for skin is used and who have a preoperative hospital stay longer than 8 days, are in risk of developping wound infection and they will require an aggressive antibiotic treatment and special postsurgical care.
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Affiliation(s)
- R Rojo
- Servicio de Cirugía Pediátrica, Hospital Universitario Materno-lnfantil Gregorio Marañón, Madrid.
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Parente A, Angulo J, Romero R, Rivas S, Tardáguila A, Corona C. [High-pressure balloon dilatation for treatment of orthotopic ureterocele]. Actas Urol Esp 2012; 36:117-20. [PMID: 21955558 DOI: 10.1016/j.acuro.2011.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2011] [Accepted: 07/19/2011] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Transurethral puncture or endoscopic unroofing is the best treatment currently used for both orthotopic and ectopic ureteroceles. However, they have a high incidence of secondary vesicoureteral reflux and subsequent procedures in both groups. We present a new technique for treatment of orthotopic ureterocele. MATERIAL AND METHODS We have analyzed 4 patients with orthotopic ureterocele (9.7 ± 6.2 months old) treated by dilatation of the meatus of the ureterocele. No patient had vesicoureteral reflux or duplicate systems. The indication was pyonephrosis in 2 children and progressive worsening of hydronephrosis in 2. Dilatation was performed with 5 or 6mm high-pressure balloon after inserting a stent with guidewire of 0.014" to the ureterocele. RESULTS There were no intraoperative or postoperative complications, surgical time being 24 ± 9minutes. All patients were discharged at 24 postoperative hours. Ureterohydronephrosis disappeared in all the children and they continue asymptomatic after 35 ± 22.5 months of follow-up. There were no cases of secondary vesicoureteral reflux and renal scan was unchanged after treatment. CONCLUSIONS High pressure balloon dilatation of the meatus in cases of orthotopic ureterocele is a fast, safe and successful surgical technique. We did not find any cases of secondary vesicoureteral reflux or subsequent procedures in our series, so we believe this may offer significant benefits over the transurethral puncture in such patients.
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Savarese G, Losco T, Parente A, Musella F, Pirozzi E, Mosca S, Casaretti L, Formisano R, Conte S, Bologna A, Mattiello G, Perrone-Filardi P. [Clinical applications of MIBG SPECT in chronic heart failure]. G Ital Cardiol (Rome) 2012; 13:91-97. [PMID: 22322548 DOI: 10.1714/1021.11141] [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: 05/31/2023]
Abstract
Heart failure is characterized by several abnormalities of sympathetic cardiac activity that can be assessed by 123I metaiodobenzylguanidine single photon emission computed tomography (MIBG SPECT). This technique may be useful in the clinical management of heart failure patients. Abnormal MIBG uptake has been demonstrated to be a predictor of death and arrhythmic events in heart failure patients with a prognostic power incremental to that of conventional risk markers; it may also be useful to identify patients at low risk of arrhythmias despite current guideline indications for an implantable cardioverter-defibrillator (ICD) or patients at high risk for arrhythmias not fulfilling ICD indications. This review will focus on the clinical applications of MIBG SPECT in chronic heart failure, on the basis of the most recent evidence.
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Affiliation(s)
- Gianluigi Savarese
- Dipartimento di Medicina Interna, Universita degli Studi, Federico II, Napoli
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Tardáguila AR, Del Cañizo A, Santos MM, Fanjul M, Corona C, Zornoza M, Parente A, Carrera N, Beléndez C, Cerdá J, Saavedra J, Molina E, García-Casillas MA, Peláez D. [Subcutaneously inserted central intravascular devices in the pediatric oncology patient: can we minimize their infection]. Cir Pediatr 2011; 24:208-213. [PMID: 23155633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Long-term indwelling central venous access devices are frequently used in pediatric patients. Their main complication is infection, that can even mean their removal. We try to identify the risk factors really involved in this complication and in their removal. We have made a retrospective review of 120 oncologic pediatric patients who received a central venous device between 2003 and 2009. We searched for epidemiologic, clinic, microbiologic and surgical risk factors. We made a comparative data analysis among: GROUP A, children who suffered device infection, GROUP B the others. Group A was divided into early infection (first month after implantation)/late infection, removed/not removed. Data were analized with statistical program SPSS. 29 suffered from leukemia, 19 from lymphoma and the main part, 72, from solid tumour. 31% experienced infection (GROUP A), being early in the 36% of them. 16% had to be withdrawn. Data analysis revealed statistical association with the age (p=0.015) and with the reception of chemiotherapic treatment the week before the surgical insertion. The rest of the studied factors did not revealed a real association, but could be guess a relationship among infection and leukemia, subclavian catheters, those patients whose deviced was introduced using a guide over a previous catheter and also transplanted. Related to early infection the only associateon founded was with the subclavian access (p=0.018). In conclusion, in our serie long-term central venous access infection was more frequent in the younger patients and also in those who had received chemotherapy the week before the catheter implantation. The tendency towards infection in leukemia, transplanted and subclavian carriers has to be studied in a prospective way with a larger number of oncologic children.
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Affiliation(s)
- A R Tardáguila
- Servicio de Cirugía Pediátrica, Hospital Gregorio Marañón, Madrid.
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Carrera N, Parente A, Rivas S, Romero R, Angulo JM. [Cold-knife retrograde endoscopic endopyelotomy (Cutting-Balloon) in children with ureteropelvic junction obstruction: early results]. Cir Pediatr 2011; 24:192-195. [PMID: 23155630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND To present our early experience in the use of Cutting-Balloon for the treatment of resistant or relapsed ureteropelvic junction obstruction (UPJO) after a prior endourological retrograde high-pressure balloon dilatation (RHPBD). MATERIALS AND METHODS Patients with progressive hydronephrosis and impaired drainage of the renal pelvis on a diuretic renal scan were treated with RHPBD. In those patients with resistant UPJO (waist persistence after dilatation) or relapsed UPJO, we consider using a Cutting-Balloon as an alternative to our current protocol (second RHPBD or open surgery). A JJ stent was placed following the procedure, and removed at 4-6 weeks. Outcomes were evaluated 3 and 6 months after stent removal, and every 6 months thereafter, repeating renal ultrasonography and diuretic renal scan. RESULTS Between 2008 and 2010 we treated with Cutting-balloon 5 patients (4 male, 1 woman) with UPJO (left side: 3 cases, right side: 1 case, bilateral: 1 case) with a mean age of 3 months (range, 10 days to 7 months). Four cases had resistant UPJO and 1 case relapsed UPJO. After the procedure, and during the follow-up period of 12 months (range, 9-18 months), no further treatment was necessary. Four patients had improvement of hydronephrosis, with normal relative renal function (RRF). One patient (RRF 18% before treatment) did not improve. No periprocedural complications occurred. CONCLUSIONS Cutting-balloon retrograde endopyelotomy seems to be a treatment with encouraging early results for resistant and relapsed UPJO, after a prior RHPBD. We believe that further clinical evaluation is needed to confirm these findings.
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Affiliation(s)
- N Carrera
- Hospital General Universitario Gregorio Marañón, Madrid.
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Perrone-Filardi P, Paolillo S, Dellegrottaglie S, Gargiulo P, Savarese G, Marciano C, Casaretti L, Cecere M, Musella F, Pirozzi E, Parente A, Cuocolo A. Assessment of cardiac sympathetic activity by MIBG imaging in patients with heart failure: a clinical appraisal. Heart 2011; 97:1828-33. [PMID: 21917663 DOI: 10.1136/heartjnl-2011-300343] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Cardiac sympathetic activity can be assessed by (123)I-labelled meta-iodobenzylguanidine (MIBG) scintigraphy. Abnormalities of sympathetic cardiac activity have been shown in patients with heart failure, resulting in reduced MIBG uptake. Abnormal MIBG uptake predicts cardiac death, arrhythmias and all-cause mortality in patients with heart failure with a prognostic power incremental to that of conventional risk markers, and may identify patients at low risk of arrhythmias despite current guideline indications for implantable cardioverter defibrillator or patients at high risk for arrhythmias not fulfilling implantable cardioverter defibrillator indications. Prospective outcome studies are needed to assess whether MIBG imaging will have an impact on the mortality and morbidity of patients with heart failure.
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Affiliation(s)
- Pasquale Perrone-Filardi
- Department of Internal Medicine, Cardiovascular and Immunological Sciences, Federico II University, Naples, Italy.
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Parente A, Angulo J, Romero R, Rivas S, Corona C, Tardáguila A. Toxina botulínica en el fracaso del cierre de derivaciones urinarias altas. Actas Urol Esp 2011. [DOI: 10.4321/s0210-48062011000700009] [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: 11/11/2022]
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Prastaro M, Paolillo S, Savarese G, Dellegrottaglie S, Scala O, Ruggiero D, Gargiulo P, Marciano C, Parente A, Cecere M, Musella F, Chianese D, Scopacasa F, Perrone-Filardi P. N-terminal pro-b-type natriuretic peptide and left atrial function in patients with congestive heart failure and severely reduced ejection fraction. Eur J Echocardiogr 2011; 12:506-13. [PMID: 21685193 DOI: 10.1093/ejechocard/jer070] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
AIMS Amino-terminal portion of pro-B-type natriuretic peptide (NT-pro-BNP) is a valuable diagnostic and prognostic marker in congestive heart failure (CHF). In CHF patients, elevation of natriuretic peptide levels correlate with decreased left ventricular (LV) ejection fraction (EF) and increased left atrial (LA) volumes, but a correlation with LA function that is a determinant of haemodynamic and clinical status in CHF with independent prognostic value has never been investigated. Aim of this study was to evaluate the relationship between cardiac neurohormonal activation and LA function in patients with CHF due to dilated cardiomyopathy. METHODS AND RESULTS One hundred and one patients (86% males; mean age, 64 ± 11 years) with dilated ischaemic or non-ischaemic cardiomyopathy, LV EF ≤45% (mean LV EF, 33 ± 8%), and New York Heart Association class II-IV underwent transthoracic echocardiography to evaluate LA fractional active and total emptying from M- and B-Mode images, and, on the same day, venous blood sample collection to dose NT-pro-BNP. By univariate analyses, NT-pro-BNP significantly correlated to age, LA dimensions, LA function indexes, EF, and functional class. At multivariate analysis, LV EF and M- or B-Mode indexes of LA function were the only independent predictors of NT-pro-BNP values. A NT-pro-BNP cut-off of 1480 pg/mL identified LA dysfunction with 89% specificity and 54% sensitivity. CONCLUSION In CHF patients with severely impaired systolic function, NT-pro-BNP levels reflect LA and LV dysfunction. These data should prompt studies to investigate the relationship between changes of LA function and NT-pro-BNP levels and their clinical value as prognostic and therapeutic targets in CHF.
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Affiliation(s)
- Maria Prastaro
- Department of Internal Medicine, Cardiovascular Sciences and Immunology, Federico II University of Naples, Via Pansini 5, Naples, Italy
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Rivas S, Romero R, Parente A, Fanjul M, Angulo J. Simplificación del tratamiento quirúrgico del pene oculto. Actas Urol Esp 2011. [DOI: 10.4321/s0210-48062011000500011] [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: 11/11/2022]
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Ferrara L, Dosi R, Di Maro A, Guida V, Cefarelli G, Pacifico S, Mastellone C, Fiorentino A, Rosati A, Parente A. Nutritional values, metabolic profile and radical scavenging capacities of wild asparagus (A. acutifolius L.). J Food Compost Anal 2011. [DOI: 10.1016/j.jfca.2010.10.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Rivas S, Romero R, Parente A, Fanjul M, Angulo J. [Simplification of the surgical treatment of a hidden penis]. Actas Urol Esp 2011; 35:310-4. [PMID: 21453989 DOI: 10.1016/j.acuro.2010.08.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2010] [Accepted: 08/09/2010] [Indexed: 10/26/2022]
Abstract
INTRODUCTION The treatment of a hidden penis consists of completely and effectively exteriorizing the penile shaft from a functional and aesthetic point of view. PATIENTS AND METHODS Over a period of 15 months (02/2008-05/2009), we treated 7 children (mean age 4.6 years) with hidden penis (five had a buried penis, one had a webbed penis and another a trapped penis) using the Borsellino reconstruction technique modified with an "S" dorsal incision. We performed a pubic lipectomy in one patient through the same incision. Surgical indication was for aesthetic reasons in all the cases, secondary phimosis in four, repeated balanitis in one and pain in another. RESULTS Hospital stay was 24 hours. With a short-term follow-up (1-12 months), we detected the following complications: partial recurrence, post-surgical lymphedema and hypertrophic scarring, each of them in one case. Patients and parents were satisfied with the result. CONCLUSIONS The technique that we present achieves good cosmetic results and has few immediate complications. The substitution of the two dorsal incisions with one "S" incision allows simultaneous lipectomy without the need for another incision.
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Romero RM, Rivas S, Parente A, Fanjul M, Angulo JM. [Injection of botulinum toxin (BTX-A) in children with bladder dysfunction due to detrusor overactivity]. Actas Urol Esp 2011; 35:89-92. [PMID: 21256633 DOI: 10.1016/j.acuro.2010.08.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [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: 04/22/2010] [Revised: 08/08/2010] [Accepted: 08/31/2010] [Indexed: 11/30/2022]
Abstract
INTRODUCTION bladder dysfunction causes urinary incontinence and kidney damage in children. When treatment with anticholinergics and intermittent bladder catheterization fails, the alternative therapy is bladder augmentation. PATIENTS AND METHODS between 2005 and 2009, a prospective study was carried out with Botox(®) injected into the detrusor of children suffering from high-pressure bladder despite anticholinergic treatment. We assessed their urodynamic, clinical and radiological evolution prior to and at 4 weeks, 6 months and 1 year after the injection (10 u/kg of weight up to 300 u). Reinjection was indicated in the event of clinical or urodynamic worsening. We employed the Wilcoxom test to statistically analyze the urodynamic parameters. RESULTS 12 patients were treated, 11 with neurogenic bladder (91.7%) and 1 with posterior urethral valves (8.4%). The mean age was 12.6 (4.3-17.8) years and follow-up took place after 40.8 (16.9-45-7) months. Bladder capacity, detrusor accommodation and pressure improved after 4 weeks in all the patients except in 2 (16.7%). This improvement decreased after 6 months, although successive injections produced similar changes. One patient (8.3%) received 1 dose, six (50%) two doses and five (41.7%) received three. Clinical and urodynamic improvement in 8 patients (66.7%) prevented bladder augmentation. CONCLUSIONS repeated botulinum toxin injection in the detrusor is a therapeutic instrument for high pressure and low accommodation bladders in children. It could replace bladder augmentation in some cases, however further studies with long-term follow-up care are required to appropriately evaluate its safety and effectiveness.
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Affiliation(s)
- R M Romero
- Sección de Urología Infantil, Servicio de Cirugía Pediátrica, Hospital Materno Infantil Gregorio Marañón, Madrid, España.
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Romero R, Rivas S, Parente A, Fanjul M, Angulo J. Es la inyección de Toxina botulínica-A en el detrusor una alternativa a la ampliación vesical en niños. Actas Urol Esp 2011. [DOI: 10.4321/s0210-48062011000200006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Romero R, Rivas S, Parente A, Fanjul M, Angulo J. Injection of botulinum toxin (BTX-A) in children with bladder dysfunction due to detrusor overactivity. ACTA ACUST UNITED AC 2011. [DOI: 10.1016/s2173-5786(11)70025-7] [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: 11/28/2022]
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Corona C, Cañizo A, Cerda J, Fanjul M, Carrera N, Tardáguila A, Zornoza M, Parente A, Angulo JM, De Tomás E, Molina E, Peláez D, García Casillas MA, Rivas S, Romero R, Marín MC. [Phimosis: dorsal slit or circumcision?]. Cir Pediatr 2011; 24:51-54. [PMID: 23155652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
INTRODUCTION Phimosis is perhaps one of the most frequent consultation on pediatric surgery clinics throught the world. The aim of this study is to compare the two procedures more frequently performed in our hospital: dorsal slit and circumcision. PATIENTS Y METHODS: Retrospective study of 1698 patients who were admitted for elective surgical treatment of phimosis between 2003 and 2009. We analyzed age, surgical and anesthethic times, surgical technique and complications. We also did transversal descriptive study through telephonic survey on parents and patients older than 16 years old. RESULTS There was 76.6% of dorsal slit (n = 1300) and 23.4% (n= 398) of circumcisions. Mean age was 7.15 years y mean time of follow up was 42.3 months. Surgical time was significantly higher in circumcision (p < 0.0001). There were 3% (n = 51) of reoperations, no differences between groups. We didn't find differences in postoperative stenosis, but bleeding was more frequent in circumcision group (1.7%; p = 0.03). There were no differences on parental appreciation of postoperative pain, or functional and esthetic satisfaction between groups. CONCLUSIONS We didn't find differences on subjective satisfaction between groups. Even if there are differences n postoperative bleeding, global incidence is very low. In our experience both techniques are valid and safe, so surgeon and parents must jointly make the decision.
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Affiliation(s)
- C Corona
- Servicio de Cirugía Pediátrica, Hospital Infantil Gregorio Marañón, Madrid.
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Filardi PP, Cecere M, Savarese G, Damore C, Parente A, Conte S, Coutsoumbas G. [Inflammation and lipids in the coronary pathology. Risk factors, causes or therapeutic target?]. G Ital Cardiol (Rome) 2010; 11:10S-15S. [PMID: 21491734] [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: 05/30/2023]
Abstract
The search for new risk markers of cardiovascular (CV) risk is continuous, aimed to improve its estimate. Among them, the measurement of C-reactive protein (CRP) levels seems the most promising one. CV risk evaluation systems as Reynolds score, integrating CPR dosage to classic risk factors, were shown to improve the detection of subjects at higher risk, who deserve a more effective CV prevention. The use of CRP as a guide in primary prevention was tested for the first time in the JUPITER study, a large randomized trial comparing rosuvastatin 20 mg and placebo. Admission criteria were based on the presence of an inflammatory status only (CRP >2 mg/l), aside from CV risk factors (LDL <130 mg/dl). Rosuvastatin 20 mg, compared to placebo, significantly reduced composite primary endpoint (CV mortality, myocardial infarction, ischemic stroke, hospitalization for unstable angina and myocardial revascularization). These results confirmed the continuous relationship between decreased cholesterol level and clinical benefit also in primary prevention. The high prevalence of metabolic syndrome in this study population confirmed the link between this condition and the presence of an inflammatory status, and the high incidence of events occurred in the placebo group suggests an important role of CRP in the detection of subjects at higher CV risk. The greatest reduction of CV events was seen in the subgroup of patient who achieved the "double target" of both decreased lipids and inflammation marker, similarly to PROVE IT-TIMI 22 in secondary prevention. The presence of an inflammatory status may allow the detection of more vulnerable patients, where statin treatment may result in a greater benefit, as both LDL cholesterol and inflammatory status are reduced, and clinical CV events are consequently decreased.
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Affiliation(s)
- Pasquale Perrone Filardi
- Dipartimento di Medicina Interna, Scienze Cardiovascolari ed Immunologiche, Università degli Studi Federico II, Napoli.
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Monda C, Scala O, Paolillo S, Savarese G, Cecere M, D'Amore C, Parente A, Musella F, Mosca S, Filardi PP. [Sleep apnea and heart failure: pathophysiology, diagnosis and therapy]. G Ital Cardiol (Rome) 2010; 11:815-822. [PMID: 21348318] [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: 05/30/2023]
Abstract
Sleep apnea, defined as a pathologic pause in breathing during sleep >10 s, promotes the progression of chronic heart failure and may be a predictor of poor prognosis. It causes, in fact, several mechanical, hemodynamic, chemical and inflammatory changes that negatively compromise cardiovascular homeostasis of heart failure patients. Sleep apnea is recognized as sleep apnea syndrome when specific symptoms, such as sleepiness and headache during the daytime and snoring, are present and is diagnosed with an overnight test called polysomnography. There are two different forms of sleep apnea, central and obstructive. Breathing is interrupted by the loss of respiratory drive and the lack of respiratory effort in the central form, which affects about 40-60% of heart failure patients. In obstructive sleep apnea, breathing stops when throat muscles relax, despite respiratory effort. This form affects about 3% of the general population, while it is present in at least 30% of heart failure patients. The diagnosis of sleep disorders in heart failure becomes very important to help patients adopting lifestyle changes and starting specific therapies to improve quality of life and retard the progression of chronic heart failure.
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Affiliation(s)
- Cinzia Monda
- Dipartimento di Medicina Interna, Scienze Cardiovascolari ed Immunologiche, Università degli Studi Federico II, Napoli
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