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Bruno MT, Caruso G, Torrisi E, Grimaldi R, Abate B, Luciani FS, Basile S, Panella MM. The Impact of Diagnosis of Human Papillomavirus (HPV) Infection and Electrosurgical Excision Procedure (LEEP) for Cervical Intraepithelial Neoplasia 3 (CIN3) on Women's Sexual Lives. Diagnostics (Basel) 2024; 14:911. [PMID: 38732325 PMCID: PMC11083130 DOI: 10.3390/diagnostics14090911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 04/24/2024] [Accepted: 04/25/2024] [Indexed: 05/13/2024] Open
Abstract
The aim of the study was to assess sexual health in women who underwent Loop Electrosurgical Excisional Procedure (LEEP) for the treatment of cervical intraepithelial neoplasia 3 (CIN 3). One hundred thirty-one women were enrolled, and the Female Sexual Function Index (FSFI) questionnaire was administered before LEEP and 6 months after the procedure. In almost all of the participants, data revealed a statistically significant worsening in sexual quality of life after LEEP. Therefore, clinicians should be aware of these possible negative effects on sexual behavior, and provide women with appropriate, wide-ranging, and detailed counseling. The data obtained in the present study should help to plan appropriate counseling from communicating HPV diagnosis and medical treatment to CIN3 surgical procedure.
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Affiliation(s)
- Maria Teresa Bruno
- Department of General Surgery and Medical-Surgical Specialties, Gynecological Clinic, University of Catania, 95123 Catania, Italy (E.T.); (R.G.)
- Multidisciplinary Research Center in Papillomavirus Pathology, University of Catania, 95123 Catania, Italy
| | - Giuseppe Caruso
- Department of General Surgery and Medical-Surgical Specialties, Gynecological Clinic, University of Catania, 95123 Catania, Italy (E.T.); (R.G.)
| | - Elena Torrisi
- Department of General Surgery and Medical-Surgical Specialties, Gynecological Clinic, University of Catania, 95123 Catania, Italy (E.T.); (R.G.)
| | - Raffaela Grimaldi
- Department of General Surgery and Medical-Surgical Specialties, Gynecological Clinic, University of Catania, 95123 Catania, Italy (E.T.); (R.G.)
| | - Biagio Abate
- Department of General Surgery and Medical-Surgical Specialties, Gynecological Clinic, University of Catania, 95123 Catania, Italy (E.T.); (R.G.)
| | - Francesco Saverio Luciani
- Methods and Models Department for the Economy, Territory and Finance, La Sapienza University of Rome, 00185 Rome, Italy;
| | - Susanna Basile
- Psychologist and Clinical Sexologist, 95123 Catania, Italy;
| | - Marco Marzio Panella
- Department of General Surgery and Medical-Surgical Specialties, Gynecological Clinic, University of Catania, 95123 Catania, Italy (E.T.); (R.G.)
- Multidisciplinary Research Center in Papillomavirus Pathology, University of Catania, 95123 Catania, Italy
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Celli A, De Crescenzo A, Abate B, Pederzini LA. Causes, symptoms, and treatments of nerve entrapments around the elbow: Current concepts. J ISAKOS 2024; 9:240-249. [PMID: 38159865 DOI: 10.1016/j.jisako.2023.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 12/23/2023] [Accepted: 12/26/2023] [Indexed: 01/03/2024]
Abstract
The elbow is a joint extremely susceptible to stiffness, even after a trivial trauma. As for other joints, several factors can generate stiffness such as immobilisation, joint incongruity, heterotopic ossification, adhesions, or pain. Prolonged joint immobilisation, pursued to assure bony and ligamentous healing, represents the most acknowledged risk factor for joint stiffness. The elbow is a common site of nerve entrapment syndromes. The reasons are multifactorial, but peculiar elbow anatomy and biomechanics play a role. Passing from the arm into the forearm, the ulnar, median, and radial nerves run at the elbow in close rapport with the joint, fibrous arches and through narrow fibro-osseous tunnel. The elbow joint, in fact, has a large range of flexion which exposes nerves lying posterior to the axis of rotation to traction and those anterior to compression.
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Affiliation(s)
- Andrea Celli
- Hesperia Hospital, Department of Orthopaedic and Traumatology Surgery, Shoulder and Elbow Unit, Modena, 41124, Italy.
| | - Angelo De Crescenzo
- Ospedale "F. Miulli", Department of Orthopaedic and Traumatology Surgery, Shoulder and Elbow Unit, Acquaviva delle Fonti, Bari, 70021, Italy
| | - Biagio Abate
- Hesperia Hospital, Department of Orthopaedic and Traumatology Surgery, Shoulder and Elbow Unit, Modena, 41124, Italy
| | - Luigi Adriano Pederzini
- Nuovo Ospedale di Sassuolo, Department of Orthopaedic, Traumatology and Arthroscopic Surgeries, Modena, 41049, Italy
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Abate B, Cozzolino A, Pederzini LA, Celli A. Current concepts of surgical approach for radial nerve entrapment around the elbow. J ISAKOS 2024:S2059-7754(24)00046-4. [PMID: 38453022 DOI: 10.1016/j.jisako.2024.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 02/28/2024] [Accepted: 03/01/2024] [Indexed: 03/09/2024]
Abstract
Radial nerve entrapment is an uncommon diagnosis. The entrapment can occur at any location within the course of the nerve distribution, but the most frequent location of entrapment occurs around the elbow and involves the posterior interosseous nerve. Several potential sites of radial nerve entrapment around the elbow are identified: the capsular tissue of the radiocapitellar joint; hypertrophic crossing branches of leash of henry; the leading proximal tendinous and medial edge of extensor carpi radialis brevis; the arcade of Frohse and distal border of the supinator between its two heads. The arcade of Frohse is the most common site of compression. The aim of this manuscript is to describe the common surgical methods to approach the radial nerve entrapments around the elbow and define the preferred surgical approach based on the site of compression.
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Affiliation(s)
- Biagio Abate
- Hesperia Hospital, Department of Orthopaedic and Traumatology Surgery, Shoulder and Elbow Unit, Modena, 41124, Italy
| | - Andrea Cozzolino
- Department of Public Health, Federico II University, Napoli 80126, Italy
| | - Luigi Adriano Pederzini
- Nuovo Ospedale di Sassuolo, Department of Orthopaedic, Traumatology and Arthroscopic Surgeries, Modena 41049, Italy
| | - Andrea Celli
- Hesperia Hospital, Department of Orthopaedic and Traumatology Surgery, Shoulder and Elbow Unit, Modena, 41124, Italy.
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Bernasconi A, Rizzo M, Izzo A, Vallefuoco S, Russo AP, Rossi V, Abate B, Guarino A, Mariconda M. Bösch osteotomy for hallux valgus correction: results at a mean 10-year follow-up. Arch Orthop Trauma Surg 2023; 143:1293-1300. [PMID: 34839385 DOI: 10.1007/s00402-021-04259-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 11/12/2021] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Bösch osteotomy (BO), which is a first metatarsal subcapital osteotomy stabilised with a K-wire, is a surgical option to correct hallux valgus (HV). The aim of this study was to assess the long-term clinical and radiographic results in a cohort of patients treated at our institution with such osteotomy. METHODS In this retrospective monocentric single-surgeon cohort study, we included 58 HVs (46 patients) who underwent HV correction by BO and were followed at a minimum of 7 years. The range of motion (ROM), the American Orthopaedic Foot and Ankle Society's Forefoot scale (AOFAS-FS) and the Visual Analogic Scale (VAS) for pain were recorded. On weightbearing radiographs, the Hallux Valgus Angle (HVA), Intermetatarsal Angle (IMA), the Distal Metatarsal Articular Angle (DMAA), and the Lateral Sesamoid Position (LSP) were measured and compared with pre-operative values. The complication rate and first metatarsophalangeal joint stiffness were also assessed. RESULTS At a mean follow-up of 10 ± 2 (7-17) years, mean ± standard deviation AOFAS-FS and VAS were 89 ± 11 (67-93) and 2.1 ± 2.8 (0-7) points, respectively. In 42 (72%) cases there was no limitation in the choice of footwears. Radiographically, we found a significant improvement in the HVA (from 33.9° ± 6.7 to 18.8° ± 5.6, p < 0.001), in the IMA (14.2° ± 3.1 to 9.4° ± 2.7, p < 0.001), in the DMAA (from 30.3° ± 6.8 to 11.5° ± 5.1, p < 0.001) and in LSP (median value from 3 to 1, p < 0.001). In 36 (62%) cases the ROM was greater than 75° while in 22 (38%) it ranged between 30° and 75°. Minor complications occurred in six (10%) cases, which did not require any further surgery at the longest follow-up. CONCLUSION Bösch technique provided satisfactory clinical and radiographic outcomes in the treatment of hallux valgus which persisted at a mean 10-year follow-up. The complication rate did not differ from more recent techniques described in literature. LEVEL OF EVIDENCE Level IV, retrospective cohort study.
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Affiliation(s)
- Alessio Bernasconi
- Orthopaedic and Traumatology Unit, Department of Public Health, University "Federico II" of Naples, Naples, Italy.
| | - Maria Rizzo
- Orthopaedic and Traumatology Unit, Department of Public Health, University "Federico II" of Naples, Naples, Italy
| | - Antonio Izzo
- Orthopaedic and Traumatology Unit, Department of Public Health, University "Federico II" of Naples, Naples, Italy
| | - Salvatore Vallefuoco
- Orthopaedic and Traumatology Unit, Department of Public Health, University "Federico II" of Naples, Naples, Italy
| | - Anna Paola Russo
- Orthopaedic and Traumatology Unit, Department of Public Health, University "Federico II" of Naples, Naples, Italy
| | - Valentina Rossi
- Orthopaedic and Traumatology Unit, Department of Public Health, University "Federico II" of Naples, Naples, Italy
| | - Biagio Abate
- Orthopaedic and Traumatology Unit, Department of Public Health, University "Federico II" of Naples, Naples, Italy
| | - Amedeo Guarino
- Orthopaedic and Traumatology Unit, Department of Public Health, University "Federico II" of Naples, Naples, Italy
| | - Massimo Mariconda
- Orthopaedic and Traumatology Unit, Department of Public Health, University "Federico II" of Naples, Naples, Italy
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Conte C, Della Corte L, Pelligra S, Bifulco G, Abate B, Riemma G, Palumbo M, Cianci S, Ercoli A. Assessment of Salvage Surgery in Persistent Cervical Cancer after Definitive Radiochemotherapy: A Systematic Review. Medicina (Kaunas) 2023; 59:medicina59020192. [PMID: 36837394 PMCID: PMC9967015 DOI: 10.3390/medicina59020192] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/15/2023] [Accepted: 01/16/2023] [Indexed: 01/21/2023]
Abstract
Background and Objectives: The standard treatment approach in locally advanced cervical cancer (LACC) is exclusive concurrent chemoradiation therapy (RTCT). The risk of local residual disease after six months from RTCT is about 20-30%. It is directly related to relapse risk and poor survival, such as in patients with recurrent cervical cancer. This systematic review aims to describe studies investigating salvage surgery's role in persistent/recurrent disease in LACC patients who underwent definitive RTCT. Materials and Methods: Studies were eligible for inclusion when patients had LACC with radiologically suspected or histologically confirmed residual disease after definitive RTCT, diagnosed with post-treatment radiological workup or biopsy. Information on complications after salvage surgery and survival outcomes had to be reported. The methodological quality of the articles was independently assessed by two researchers with the Newcastle-Ottawa scale. Following the recommendations in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, we systematically searched the PubMed, Scopus, Cochrane, Medline, and Medscape databases in May 2022. We applied no language or geographical restrictions but considered only English studies. We included studies containing data about postoperative complications and survival outcomes. Results: Eleven studies fulfilled the inclusion criteria and all were retrospective observational studies. A total of 601 patients were analyzed concerning the salvage surgery in LACC patients for persistent/recurrent disease after RTCT treatment. Overall, 369 (61.4%) and 232 (38.6%) patients underwent a salvage hysterectomy (extrafascial or radical) and pelvic exenteration (anterior, posterior, or total), respectively. Four hundred and thirty-nine (73%) patients had histologically confirmed the residual disease in the salvage surgical specimen, and 109 patients had positive margins (overall range 0-43% of the patients). The risk of severe (grade ≥ 3) postoperative complications after salvage surgery is 29.8% (range 5-57.5%). After a median follow-up of 38 months, the overall RR was about 32% with an overall death rate of 40% after hysterectomy or pelvic exenteration with or without lymphadenectomy. Conclusions: There is heterogeneity between the studies both in their design and results, therefore the effect of salvage surgery on survival and recurrence cannot be adequately estimated. Future homogeneous studies with an appropriately selected population are needed to analyze the safety and efficacy of salvage hysterectomy or pelvic exenteration in patients with residual tumors after definitive RTCT.
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Affiliation(s)
- Carmine Conte
- Department of General Surgery and Medical-Surgical Specialties, Institute of Obstetrics and Ginecology, A.O.U. Policlinico Rodolico—San Marco, University of Catania, 95125 Catania, Italy
- Correspondence: ; Tel.: +39-3290-275-147
| | - Luigi Della Corte
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, 80131 Naples, Italy
| | - Silvia Pelligra
- Department of Woman and Child Health and Public Health, Catholic University of the Sacred Heart, 00168 Rome, Italy
| | - Giuseppe Bifulco
- Department of Public Health, University of Naples Federico II, 80131 Naples, Italy
| | - Biagio Abate
- Department of General Surgery and Medical-Surgical Specialties, Institute of Obstetrics and Ginecology, A.O.U. Policlinico Rodolico—San Marco, University of Catania, 95125 Catania, Italy
| | - Gaetano Riemma
- Department of Woman, Child and General and Specialized Surgery, Luigi Vanvitelli University of Campania, 81100 Naples, Italy
| | - Marco Palumbo
- Department of General Surgery and Medical-Surgical Specialties, Institute of Obstetrics and Ginecology, A.O.U. Policlinico Rodolico—San Marco, University of Catania, 95125 Catania, Italy
| | - Stefano Cianci
- Unit of Gynecology and Obstetrics, Department of Human Pathology of Adult and Childhood “G. Barresi”, University of Messina, 98121 Messina, Italy
| | - Alfredo Ercoli
- Unit of Gynecology and Obstetrics, Department of Human Pathology of Adult and Childhood “G. Barresi”, University of Messina, 98121 Messina, Italy
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Abstract
OBJECTIVE We compared the pharmacokinetics of two methods for dosing gentamicin for the treatment of postpartum endometritis with the goal of achieving adequate peak serum concentrations (>12 mg/L) and prolonged trough levels below 2 mg/L. METHODS Group-I subjects (n = 5) received intravenous gentamicin, 5 mg/kg per total body weight over 60 min., with a maximum dose of 500 mg. Group-II subjects (n = 17) were dosed intravenously according to the following formula: Dose = desired peak concentration (fixed at 14 mg/L) * (volume of distribution, i.e., 0.35 L/kg) * adjusted body weight (in kilograms). Serum gentamicin levels were obtained 1 hr. and 8-12 hr. after infusion of the second dose. Pharmacokinetic parameters for the subjects in each group were calculated according to standard formulas. RESULTS Subjects in Group I had significantly higher doses and peak drug concentrations (P < 0.01), while in Group II, 76% of patients had peak levels less than desired (<12 mg/L). Both groups maintained trough levels of <2 mg/L in excess of 12 hr. CONCLUSIONS Changing to the adjusted body weight formula for Group I, while maintaining a dose between 4 and 5 mg/kg, would reduce excessive peak concentrations. Using a calculated volume of distribution of 0.4 L/kg in Group II would improve peak serum concentrations to the desired levels. Both dosing regimens ensure adequate aminoglycoside pharmacokinetic parameters and avoid the need for monitoring serial serum drug concentrations, provided the expected clinical response is also achieved. While the first dosing formula is simpler to calculate, the second dosing formula allows for more individualized dosing considerations.
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Affiliation(s)
- C Liu
- Department of Pharmacy, Detroit Medical Center and Wayne State University, MI, USA
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Liu C, Abate B, Reyes M, Gonik B. Single daily dosing of gentamicin: pharmacokinetic comparison of two dosing methodologies for postpartum endometritis. Infect Dis Obstet Gynecol 1999. [PMID: 10371471 PMCID: PMC1784732 DOI: 10.1002/(sici)1098-0997(1999)7:3<133::aid-idog4>3.0.co;2-h] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE We compared the pharmacokinetics of two methods for dosing gentamicin for the treatment of postpartum endometritis with the goal of achieving adequate peak serum concentrations (>12 mg/L) and prolonged trough levels below 2 mg/L. METHODS Group-I subjects (n = 5) received intravenous gentamicin, 5 mg/kg per total body weight over 60 min., with a maximum dose of 500 mg. Group-II subjects (n = 17) were dosed intravenously according to the following formula: Dose = desired peak concentration (fixed at 14 mg/L) * (volume of distribution, i.e., 0.35 L/kg) * adjusted body weight (in kilograms). Serum gentamicin levels were obtained 1 hr. and 8-12 hr. after infusion of the second dose. Pharmacokinetic parameters for the subjects in each group were calculated according to standard formulas. RESULTS Subjects in Group I had significantly higher doses and peak drug concentrations (P < 0.01), while in Group II, 76% of patients had peak levels less than desired (<12 mg/L). Both groups maintained trough levels of <2 mg/L in excess of 12 hr. CONCLUSIONS Changing to the adjusted body weight formula for Group I, while maintaining a dose between 4 and 5 mg/kg, would reduce excessive peak concentrations. Using a calculated volume of distribution of 0.4 L/kg in Group II would improve peak serum concentrations to the desired levels. Both dosing regimens ensure adequate aminoglycoside pharmacokinetic parameters and avoid the need for monitoring serial serum drug concentrations, provided the expected clinical response is also achieved. While the first dosing formula is simpler to calculate, the second dosing formula allows for more individualized dosing considerations.
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Affiliation(s)
- C Liu
- Department of Pharmacy, Detroit Medical Center and Wayne State University, MI, USA
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