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Vendeville B, Fabbri C, Roche O, Peduzzi L, Sirveaux F. Treatment of presumed aseptic non-union of the humeral shaft by osteosynthesis combining intramedullary nailing and screw plate. Acta Orthop Belg 2024; 90:102-109. [PMID: 38669658 DOI: 10.52628/90.1.11809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2024]
Abstract
In 2020, the most common treatment for presumed aseptic non-union of the humeral shaft seems to be decortication, often associated with bone autografting, and stabilized by a screw plate. We propose to evaluate an original technique of rigid osteosynthesis combining intramedullary nailing and screw plate. Between January 2004 and January 2020, 45 patients underwent treatment of presumed aseptic non-union of the humeral shaft by osteosynthesis combining intramedullary nailing and a screw plate. The minimum radio-clinical follow-up was one year postoperatively. The series included 19 men and 26 women with a mean age of 53 years (range 19-84 years). Bone consolidation was achieved in 43 patients, a rate of 95.5%. Comparing patients who achieved bone consolidation with the two failed consolidations did not reveal any statistically significant factor. Interobserver agreement was almost perfect (k=0.93) for the use of the RUST for humeral shaft fractures treated with intramedullary nailing and screw plate. In our study, the treatment of presumed aseptic non- union of the humeral shaft with an osteosynthesis combining intramedullary nailing and screw plate gives, with 95.5% of bone consolidation, results equal to or even superior to the different treatments currently described in the literature.
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Cennamo V, Landi S, Aragona G, Colecchia A, Conigliaro R, Di Lorenzo D, Di Marco M, Fabbri C, Falcone P, Gaiani F, Manno M, Merighi A, Mussetto A, Peghetti A, Sassateli R, Solfrini V, Zagari RM, Arena R, Bertani H, Binda C, Boarino V, De Padova A, Feletti V, Fuccio L, Iori V, Nervi G, Prati GM, Soriani P, De Palma R. The management of endoscopic retrograde cholangio- pancreatography-related infections risk: results of an italian survey at regional level. Ann Ig 2023; 35:84-91. [PMID: 35442386 DOI: 10.7416/ai.2022.2518] [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] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND AND AIM Among the Endoscopic retrograde cholangiopancreatography (ERCP) adverse events, an increasingly arising problem is the transmission of Multi Drug Resistant (MDR) Bacteria through duodenoscopes. The aim of this survey was to evaluate the current clinical practice of management of ERCP associated infections in Emilia-Romagna, Italy. METHODS An online survey was developed including 12 questions on management of ERCP associated infections risk. The survey was proposed to all 12 endoscopy centers in Emilia Romagna that perform at least > 200 ERCPs per year. RESULTS 11 centers completed the survey (92%). Among all risk factors of ERCP infections, hospitalization in intensive care units, immunosuppressant therapies, and previous MDR infections have achieved a 80 % minimum of concurrence by our respondents. The majority of them did not have a formalized document in their hospital describing categories and risk factors helpful in the detection of patients undergoing ERCP with an high-level infective risk (9/11, 82%). Most centers (8/11, 72%) do not perform screening in patients at risk of ERCP infections. Post procedural monitoring is performed by 6 of 11 centers (55%). CONCLUSION Our survey showed that, at least at regional level, there is a lack of procedures and protocols related to the management of patients at risk of ERCP infections.
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Affiliation(s)
- V Cennamo
- Gastroenterology and Interventional Endoscopy Unit, Bellaria-Maggiore Hospital, AUSL of Bologna, Italy
| | - S Landi
- Gastroenterology and Interventional Endoscopy Unit, Bellaria-Maggiore Hospital, AUSL of Bologna, Italy
| | - G Aragona
- Department of Internal Medicine, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - A Colecchia
- Gastroenterology Unit, Department of Medical Specialties, Azienda Ospedaliero-Universitaria and University of Modena and Reggio Emilia, Modena, Italy
| | - R Conigliaro
- Digestive Endoscopy Unit, Ospedale Civile di Baggiovara, Azienda Ospedaliero-Universitaria di Modena, Italy
| | - D Di Lorenzo
- Territorial Assistance Service - Pharmacy and Medical Devices Area, AUSL of Bologna, Italy
| | - M Di Marco
- Gastroenterology and Digestive Endoscopy Unit, Ospedale Infermi Rimini, AUSL della Romagna, Italy
| | - C Fabbri
- Gastroenterology and Digestive Endoscopy Unit, Forlì-Cesena Hospitals, AUSL della Romagna, Italy
| | - P Falcone
- Territorial Assistance Service - Pharmacy and Medical Devices Area, AUSL of Bologna, Italy
| | - F Gaiani
- Gastroenterology and Endoscopy Unit, University Hospital of Parma, Italy
| | - M Manno
- Gastroenterology and Digestive Endoscopy Unit, AUSL Modena, Carpi Hospital and Modena District Network of Gastro-enterology, Italy
| | - A Merighi
- Gastroenterology and Digestive Endoscopy Unit, University Hospital Sant'Anna, Ferrara, Italy
| | - A Mussetto
- Gastroenterology Unit, Santa Maria delle Croci Hospital, Ravenna, Italy
| | - A Peghetti
- Territorial Assistance Service - Pharmacy and Medical Devices Area, AUSL of Bologna, Italy
| | - R Sassateli
- Gastroenterology and Digestive Endoscopy Unit, Azienda USL - IRCCS di Reggio Emilia, Italy
| | - V Solfrini
- Territorial Assistance Service - Pharmacy and Medical Devices Area, AUSL of Bologna, Italy
| | - R M Zagari
- Gastroenterology Unit, Department of Medical and Surgical Sciences, IRCCS Azienda Ospedaliero-Universitaria and University of Bologna, Italy
| | - R Arena
- Gastroenterology and Digestive Endoscopy Unit, University Hospital Sant'Anna, Ferrara, Italy
| | - H Bertani
- Digestive Endoscopy Unit, Ospedale Civile di Baggiovara, Azienda Ospedaliero-Universitaria di Modena, Italy
| | - C Binda
- Gastroenterology and Digestive Endoscopy Unit, Forlì-Cesena Hospitals, AUSL della Romagna, Italy
| | - V Boarino
- Gastroenterology Unit, Department of Medical Specialties, Azienda Ospedaliero-Universitaria and University of Modena and Reggio Emilia, Modena, Italy
| | - A De Padova
- Gastroenterology and Digestive Endoscopy Unit, Ospedale Infermi Rimini, AUSL della Romagna, Italy
| | - V Feletti
- Gastroenterology Unit, Santa Maria delle Croci Hospital, Ravenna, Italy
| | - L Fuccio
- Gastroenterology Unit, Department of Medical and Surgical Sciences, IRCCS Azienda Ospedaliero-Universitaria and University of Bologna, Italy
| | - V Iori
- Gastroenterology and Digestive Endoscopy Unit, Azienda USL - IRCCS di Reggio Emilia, Italy
| | - G Nervi
- Gastroenterology and Endoscopy Unit, University Hospital of Parma, Italy
| | - G M Prati
- Department of Internal Medicine, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - P Soriani
- Gastroenterology and Digestive Endoscopy Unit, AUSL Modena, Carpi Hospital and Modena District Network of Gastro-enterology, Italy
| | - R De Palma
- Hospital Care Service, AUSL Bologna, Italy
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Mutz J, Hoppen T, Fabbri C, Lewis C. Anxiety disorders and age-related changes in physiology. Eur Psychiatry 2022. [PMCID: PMC9566825 DOI: 10.1192/j.eurpsy.2022.487] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Anxiety disorders are leading contributors to the global disease burden, highly prevalent across the lifespan, and associated with substantially increased morbidity and early mortality. Objectives The aim of this study was to examine age-related changes across a wide range of physiological measures in middle-aged and older adults with a lifetime history of anxiety disorders compared to healthy controls. Methods The UK Biobank study recruited >500,000 adults, aged 37-73, between 2006-2010. We used generalised additive models to estimate non-linear associations between age and hand-grip strength, cardiovascular function, body composition, lung function and heel bone mineral density in cases vs. controls. Results The main dataset included 332,078 adults (mean age = 56.37 years; 52.65% females). In both sexes, individuals with anxiety disorders had lower hand-grip strength and blood pressure than healthy controls, while their pulse rate and body composition measures were higher. Case-control differences were larger when considering individuals with chronic and/or severe anxiety disorders, and differences in body composition were modulated by depression comorbidity status. Differences in age-related physiological changes between female anxiety disorder cases and healthy controls were most evident for blood pressure, pulse rate and body composition, while in males for hand-grip strength, blood pressure and body composition. Most differences in physiological measures between cases and controls tended to decrease with age increase. Conclusions Individuals with a lifetime history of anxiety disorders differed from healthy controls across multiple physiological measures, with some evidence of case-control differences by age. The differences observed varied by chronicity/severity and depression comorbidity. Disclosure JM receives studentship funding from the Biotechnology and Biological Sciences Research Council (BBSRC) and Eli Lilly and Company Limited. CML is a member of the Scientific Advisory Board of Myriad Neuroscience. CF and THH declare no relevant conflict of
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Bartova L, Fugger G, Dold M, Mitschek M, Zohar J, Mendlewicz J, Souery D, Montgomery S, Fabbri C, Serretti A, Kasper S. Psychotherapy employed additionally to Psychopharmacotherapy is not related to Better Treatment Outcome in Major Depressive Disorder. Eur Psychiatry 2022. [PMCID: PMC9567182 DOI: 10.1192/j.eurpsy.2022.229] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Although numerous effective antidepressant (AD) strategies are available for the treatment of major depressive disorder (MDD), many patients do not achieve satisfactory treatment response. Objectives The aims of the present European, cross-sectional, multicenter, naturalistic study were (1) to determine the proportion of patients suffering from primary MDD who received additional psychotherapy to their ongoing psychopharmacotherapy and (2) to identify the associated socio-demographic and clinical patterns. Methods Patients receiving both treatments were compared to those lacking concomitant additional psychotherapy that was manual-driven psychotherapy (MDP) in all cases. Results While 68.8% of a total of 1279 MDD patients received exclusively psychopharmacotherapy, 31.2% underwent a psychopharmacotherapy-MDP combination. The latter patient population was rather younger, higher educated, employed, exhibited an earlier mean age of MDD onset, lower severity of current depressive symptoms with lower odds of suicidality and higher rates of melancholic features, and comorbid asthma and migraine, and was generally treated with lower daily doses of their first-line ADs. Whereas agomelatine was more commonly dispensed in these patients, selective serotonin reuptake inhibitors were more often prescribed in MDD patients lacking additional MDP. No significant between-group differences were detected in terms of treatment outcome. Conclusions The fact that the employment of additional MDP was not related to better treatment outcome in MDD represents our major and clinically most relevant finding. Generally, MDP was employed in a minority of our patients who experienced rather beneficial socio-demographic and clinical characteristics. This might reflect an inferior accessibility of these psychotherapeutic techniques for patients who are more severely ill and less socio-economically privileged. Disclosure References Bartova L, Fugger G, Dold M, Swoboda MMM, Zohar J, Mendlewicz J, Souery D, Montgomery S, Fabbri C, Serretti A, Kasper S. Combining psychopharmacotherapy and psychotherapy is not associated with better treatment outcome in major depressive disor
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Ravaglia V, Angelini L, Bertolini M, Della Gala G, Fabbri C, Fabbri S, Farnedi S, Vacchieri I, Golinelli P, Guerra G, Ortenzia O, Pagan L, Savini A, Scrittori N, Venturi G. Small-size details detection performance of digital breast tomosynthesis, synthetic 2D and conventional full-field digital mammography images for different mammography systems: a multicenter study. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00240-x] [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: 11/28/2022] Open
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Ravaglia V, Angelini L, Bertolini M, Della Gala G, Fabbri C, Fabbri S, Farnedi S, Vacchieri I, Guerra G, Lorenzini E, Mazzocchi S, Niespolo A, Ortenzia O, Pagan L, Quattrocchi M, Savini A, Scrittori N, Venturi G, Golinelli P. Average glandular dose in digital breast tomosynthesis systems: a multicenter study. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00239-3] [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: 10/19/2022] Open
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Fabbri C, Casadei AV, Del Dottore F, Busca F, Giorgetti G, Rustignoli M, Pagan S, Marchi G, Venturi M, Casi M, Sanniti S. Radioactive medical waste management in a nuclear medicine unit with therapeutic and diagnostic administrations: optimization strategies. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00544-0] [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: 11/25/2022] Open
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Malagutti N, Fancello V, Cariani A, Battistini F, Fabbri C, Di Laora A, Valpiani G, Morotti C, Iannini V, Borin M, Ravani A, Bianchini C, Ciorba A, Stomeo F, Pelucchi S. Ion concentrations in nasal airway surface liquid: a prediction model for the identification of cystic fibrosis carriers. Rhinology 2021; 59:470-474. [PMID: 34398939 DOI: 10.4193/rhin21.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Cystic fibrosis (CF) carriers seem to have a higher risk to develop chronic rhino-sinusitis (CRS), although the full underlying mechanisms are unknown. Ion concentrations in nasal airway surface liquid (ASL) may be influenced by the heterozygosity for CF gene mutation, with possible impacts on the development of CRS. METHODS A cheap and feasible standardized technique was designed to measure the ion levels in nasal ASL. With this purpose we collected, under basal conditions, samples from the nasal cavity of 165 adults: 14 homozygous for CF, 83 carriers and 68 healthy controls. Sodium (Na) and Chlorine (Cl) concentrations were then evaluated among different groups. RESULTS Statistical analysis revealed a significant difference of Na and Cl values between controls and carriers and between controls and homozygotes. Receiver operating characteristic (ROC) curves and derived indicators (Youden's index and Area Under the Curve, AUC) were used to further evaluate the diagnostic capability of Na and Cl concentrations to differentiate heterozygotes from controls. ROC curves demonstrated that the optimal diagnostic cut-off value of Na is at 124, and the optimal cut-off value of Cl is at 103,2. CONCLUSION ASL sampling can be considered a new diagnostic tool for providing quantitative information on nasal ion composition. According to our findings, Na and Cl concentrations of nasal ASL could represent a useful tool to assess heterozygotes and healthy controls.
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Affiliation(s)
- N Malagutti
- ENT and Audiology Unit, Department of Neuroscience and Rehabilitation, University Hospital of Ferrara, Ferrara, Italy
| | - V Fancello
- ENT and Audiology Unit, Department of Neuroscience and Rehabilitation, University Hospital of Ferrara, Ferrara, Italy
| | - A Cariani
- Department of Biochemistry and Molecular Biology, University of Ferrara, Ferrara, Italy
| | - F Battistini
- Cystic Fibrosis Regional Center, Bufalini Hospital, Cesena, Italy
| | - C Fabbri
- ENT and Audiology Unit, Department of Neuroscience and Rehabilitation, University Hospital of Ferrara, Ferrara, Italy
| | - A Di Laora
- ENT and Audiology Unit, Department of Neuroscience and Rehabilitation, University Hospital of Ferrara, Ferrara, Italy
| | - G Valpiani
- Research Innovation Office, S. Anna University Hospital of Ferrara, Ferrara, Italy
| | - C Morotti
- Research Innovation Office, S. Anna University Hospital of Ferrara, Ferrara, Italy
| | - V Iannini
- ENT and Audiology Unit, Department of Neuroscience and Rehabilitation, University Hospital of Ferrara, Ferrara, Italy
| | - M Borin
- ENT and Audiology Unit, Department of Neuroscience and Rehabilitation, University Hospital of Ferrara, Ferrara, Italy
| | - A Ravani
- Unit of Medical Genetics Unit, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - C Bianchini
- ENT and Audiology Unit, Department of Neuroscience and Rehabilitation, University Hospital of Ferrara, Ferrara, Italy
| | - A Ciorba
- ENT and Audiology Unit, Department of Neuroscience and Rehabilitation, University Hospital of Ferrara, Ferrara, Italy
| | - F Stomeo
- ENT and Audiology Unit, Department of Neuroscience and Rehabilitation, University Hospital of Ferrara, Ferrara, Italy
| | - S Pelucchi
- ENT and Audiology Unit, Department of Neuroscience and Rehabilitation, University Hospital of Ferrara, Ferrara, Italy
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Masci A, D"alessandro N, Scivoletto A, Severi S, Ansaloni F, Dal Monte A, Tomasi C, Fabbri C, Corsi C. Endocardial left atrial appendage occlusion in atrial fibrillation: computational fluid dynamics simulations to assess stroke risk. Europace 2021. [DOI: 10.1093/europace/euab116.173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Percutaneous endocardial left atrial appendage (LAA) occlusion (LAAO) in non-valvular atrial fibrillation (AF) seems comparable to anticoagulation therapy (OAC) as regards thromboembolic risk reduction with a possible additional decrease in major bleeding. LAAO is currently limited to patients with contraindications to OAC, due to its high costs and procedural risks, but better pre-procedural planning and operative techniques might improve the outcome widening practical indications. Computational fluid dynamics (CFD) represents a valuable non-invasive approach to estimate physiologically significant hemodynamic parameters in a complex fluid dynamics system. It might provide a helpful in silico simulation of blood flow patterns within the LA and LAA by using 3D patient-specific models, allowing LAAO planning and effects prediction.
Purpose
This study’s aim was to simulate the fluid dynamics effects of LAAO in AF patients to predict patient-specific hemodynamic changes caused by applying the two most popular devices.
Methods
LAAO was simulated on the 3D LA anatomical models obtained from CT data in 5 AF patients, considering the device specific shape. CFD simulations in AF condition were performed both on the whole LA model and on the models with the LAAO performed with the two devices. Significant fluid dynamics indices (blood velocity, vortex structures, LAA ostium velocity, LA blood stasis) were computed to evaluate the changes in the flow patterns after LAAO in relation to the thrombogenic risk.
Results
Overall we found a more effective washout within the LA after LAAO, in terms of a different spatial distribution of velocities (see figure for a qualitative evaluation of LA blood flow velocity in one patient: (A) model with LA and LAA; models after LAAO applying the Amulet (B) and the Watchman (C) device) and vortex structures (after LAAO, they were decreased in number and increased in size). Moreover, a higher velocity at the mitral valve and at the LAA ostium (peak velocity: 12-17 cm/s in the models with LAA, 40-60 cm/s in LAAO_A and 35-65 in LAAO_W) was detected together with a slightly improved washout effect in terms of blood stasis with the Watchman device (stasis: 3.1-5.7% in the models with LAA, 1.9-4.1% in LAAO_A, 1.7-3.7% in LAAO_W).
Conclusions
A workflow for simulating the fluid dynamics effects of endocardial LAAO in AF was developed and tested. CFD provides a valuable tool to quantify hemodynamic changes after LAAO and assess thrombogenic risk in patient-specific LA and LAA. Our preliminary results suggest that endocardial LAAO favourably affects blood fluid dynamics in the LA. Abstract figure
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Affiliation(s)
- A Masci
- DEI, University of Bologna, Bologna, Italy
| | | | | | - S Severi
- DEI, University of Bologna, Bologna, Italy
| | - F Ansaloni
- Santa Maria delle Croci Hospital, AUSL della Romagna, Ravenna, Italy
| | - A Dal Monte
- Santa Maria delle Croci Hospital, AUSL della Romagna, Ravenna, Italy
| | - C Tomasi
- Santa Maria delle Croci Hospital, AUSL della Romagna, Ravenna, Italy
| | - C Fabbri
- DEI, University of Bologna, Bologna, Italy
| | - C Corsi
- DEI, University of Bologna, Bologna, Italy
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Leonessi M, Tubertini P, Longanesi A, Malaguti E, Guicciardi S, Fabbri C. Peri-operative elective path optimization through algorithms in the Local Health Authority of Bologna. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
High costs of healthcare and population ageing force the health system to constantly improve its efficiency in order to provide patients the best possible care with the available resources. In this perspective, the Local Health Authority and the University of Bologna started an experimentation to re-organize, manage and control the peri-operative elective path of general surgery, a discipline that works in a multiplatform environment according to a Hub & Spoke logic.
Methods
The experimentation is built on two mathematical programming models. The first one defines patient preparation appointments (i.e. diagnostic and anesthesiologic visits), harmonizing patient preparation with available resources, and planning migration from Hub to Spoke platforms, in order to optimize waiting time and facilities utilization. The second model defines weekly optimal admission plans. Both models consider the availability of resources in terms of surgical teams, operating room slots and number of beds for each operating unit. The proposed approach works on a four-week time horizon following a rolling horizon framework (weekly update) in order to effectively manage high priority patients.
Results
Both models have been tested on real-world instances over a six-month observation period. Overall, it was possible to increase the efficiency of surgical programming by reducing the waiting times for surgical interventions in over 20% of cases of high priority patiets in four local departments.
Conclusions
The proposed model represents one of the few cases in Italy of surgical programming developed through mathematical models. It will be necessary to evaluate the evolution of its effectiveness to optimize the system's ability to respond to the growing health needs of the population.
Key messages
Mathematical models are needed to optimize surgical planning. Efficiency of surgical planning may reduce waiting times for high priority procedures.
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Affiliation(s)
- M Leonessi
- DEI, University of Bologna, Bologna, Italy
| | | | - A Longanesi
- Health Directorate, AOSP Bologna, Bologna, Italy
| | - E Malaguti
- DEI, University of Bologna, Bologna, Italy
| | - S Guicciardi
- Health Directorate, AUSL Bologna, Bologna, Italy
| | - C Fabbri
- DEI, University of Bologna, Bologna, Italy
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Fabbri C, Fugazza A, Binda C, Zerbi A, Jovine E, Cennamo V, Repici A, Anderloni A. V.01.6 BEYOND PALLIATION: USING EUS-GUIDED CHOLEDOCHODUODENOSTOMY WITH A LUMEN-APPOSING METAL STENT AS A BRIDGE TO SURGERY. Dig Liver Dis 2019. [DOI: 10.1016/s1590-8658(19)30236-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
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Kautzky A, Dold M, Bartova L, Spies M, Kranz GS, Souery D, Montgomery S, Mendlewicz J, Zohar J, Fabbri C, Serretti A, Lanzenberger R, Dikeos D, Rujescu D, Kasper S. Clinical factors predicting treatment resistant depression: affirmative results from the European multicenter study. Acta Psychiatr Scand 2019; 139:78-88. [PMID: 30291625 PMCID: PMC6586002 DOI: 10.1111/acps.12959] [Citation(s) in RCA: 78] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/15/2018] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Clinical variables were investigated in the 'treatment resistant depression (TRD)- III' sample to replicate earlier findings by the European research consortium 'Group for the Study of Resistant Depression' (GSRD) and enable cross-sample prediction of treatment outcome in TRD. EXPERIMENTAL PROCEDURES TRD was defined by a Montgomery and Åsberg Depression Rating Scale (MADRS) score ≥22 after at least two antidepressive trials. Response was defined by a decline in MADRS score by ≥50% and below a threshold of 22. Logistic regression was applied to replicate predictors for TRD among 16 clinical variables in 916 patients. Elastic net regression was applied for prediction of treatment outcome. RESULTS Symptom severity (odds ratio (OR) = 3.31), psychotic symptoms (OR = 2.52), suicidal risk (OR = 1.74), generalized anxiety disorder (OR = 1.68), inpatient status (OR = 1.65), higher number of antidepressants administered previously (OR = 1.23), and lifetime depressive episodes (OR = 1.15) as well as longer duration of the current episode (OR = 1.022) increased the risk of TRD. Prediction of TRD reached an accuracy of 0.86 in the independent validation set, TRD-I. CONCLUSION Symptom severity, suicidal risk, higher number of lifetime depressive episodes, and comorbid anxiety disorder were replicated as the most prominent risk factors for TRD. Significant predictors in TRD-III enabled robust prediction of treatment outcome in TRD-I.
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Affiliation(s)
- A. Kautzky
- Department of Psychiatry and PsychotherapyMedical University of ViennaViennaAustria
| | - M. Dold
- Department of Psychiatry and PsychotherapyMedical University of ViennaViennaAustria
| | - L. Bartova
- Department of Psychiatry and PsychotherapyMedical University of ViennaViennaAustria
| | - M. Spies
- Department of Psychiatry and PsychotherapyMedical University of ViennaViennaAustria
| | - G. S. Kranz
- Department of Psychiatry and PsychotherapyMedical University of ViennaViennaAustria,Department of Rehabilitation SciencesThe Hong Kong Polytechnic UniversityHung HomHong Kong
| | - D. Souery
- Universit_e Libre de Bruxelles and Psy Pluriel Centre Europ_een de Psychologie MedicaleBrusselsBelgium
| | | | - J. Mendlewicz
- School of MedicineFree University of BrusselsBrusselsBelgium
| | - J. Zohar
- Psychiatric DivisionChaim Sheba Medical CenterRamat GanIsrael
| | - C. Fabbri
- Department of Biomedical and NeuroMotor SciencesUniversity of BolognaBolognaItaly
| | - A. Serretti
- Department of Biomedical and NeuroMotor SciencesUniversity of BolognaBolognaItaly
| | - R. Lanzenberger
- Department of Psychiatry and PsychotherapyMedical University of ViennaViennaAustria
| | - D. Dikeos
- Department of PsychiatryAthens University Medical SchoolAthensGreece
| | - D. Rujescu
- University Clinic for Psychiatry, Psychotherapy and PsychosomaticMartin‐Luther‐University Halle‐WittenbergHalleGermany
| | - S. Kasper
- Department of Psychiatry and PsychotherapyMedical University of ViennaViennaAustria
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Caraci F, Calabrese F, Molteni R, Bartova L, Dold M, Leggio GM, Fabbri C, Mendlewicz J, Racagni G, Kasper S, Riva MA, Drago F. International Union of Basic and Clinical Pharmacology CIV: The Neurobiology of Treatment-resistant Depression: From Antidepressant Classifications to Novel Pharmacological Targets. Pharmacol Rev 2018; 70:475-504. [PMID: 29884653 DOI: 10.1124/pr.117.014977] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Major depressive disorder is one of the most prevalent and life-threatening forms of mental illnesses and a major cause of morbidity worldwide. Currently available antidepressants are effective for most patients, although around 30% are considered treatment resistant (TRD), a condition that is associated with a significant impairment of cognitive function and poor quality of life. In this respect, the identification of the molecular mechanisms contributing to TRD represents an essential step for the design of novel and more efficacious drugs able to modify the clinical course of this disorder and increase remission rates in clinical practice. New insights into the neurobiology of TRD have shed light on the role of a number of different mechanisms, including the glutamatergic system, immune/inflammatory systems, neurotrophin function, and epigenetics. Advances in drug discovery processes in TRD have also influenced the classification of antidepressant drugs and novel classifications are available, such as the neuroscience-based nomenclature that can incorporate such advances in drug development for TRD. This review aims to provide an up-to-date description of key mechanisms in TRD and describe current therapeutic strategies for TRD before examining novel approaches that may ultimately address important neurobiological mechanisms not targeted by currently available antidepressants. All in all, we suggest that drug targeting different neurobiological systems should be able to restore normal function but must also promote resilience to reduce the long-term vulnerability to recurrent depressive episodes.
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Affiliation(s)
- F Caraci
- Departments of Drug Sciences (F.Car.) and Biomedical and Biotechnological Sciences, School of Medicine (G.M.L., F.D.), University of Catania, Catania, Italy; Oasi-Research-Institute-IRCCS, Troina, Italy (F.Car.); Departments of Pharmacological and Biomolecular Sciences (F.Cal., G.R., M.A.R.) and Medical Biotechnology and Translational Medicine (R.M.), Università degli Studi di Milano, Milan, Italy; Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria (L.B., M.D., S.K.); Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy (C.F.); and School of Medicine, Universite' Libre de Bruxelles, Bruxelles, Belgium (J.M.)
| | - F Calabrese
- Departments of Drug Sciences (F.Car.) and Biomedical and Biotechnological Sciences, School of Medicine (G.M.L., F.D.), University of Catania, Catania, Italy; Oasi-Research-Institute-IRCCS, Troina, Italy (F.Car.); Departments of Pharmacological and Biomolecular Sciences (F.Cal., G.R., M.A.R.) and Medical Biotechnology and Translational Medicine (R.M.), Università degli Studi di Milano, Milan, Italy; Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria (L.B., M.D., S.K.); Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy (C.F.); and School of Medicine, Universite' Libre de Bruxelles, Bruxelles, Belgium (J.M.)
| | - R Molteni
- Departments of Drug Sciences (F.Car.) and Biomedical and Biotechnological Sciences, School of Medicine (G.M.L., F.D.), University of Catania, Catania, Italy; Oasi-Research-Institute-IRCCS, Troina, Italy (F.Car.); Departments of Pharmacological and Biomolecular Sciences (F.Cal., G.R., M.A.R.) and Medical Biotechnology and Translational Medicine (R.M.), Università degli Studi di Milano, Milan, Italy; Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria (L.B., M.D., S.K.); Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy (C.F.); and School of Medicine, Universite' Libre de Bruxelles, Bruxelles, Belgium (J.M.)
| | - L Bartova
- Departments of Drug Sciences (F.Car.) and Biomedical and Biotechnological Sciences, School of Medicine (G.M.L., F.D.), University of Catania, Catania, Italy; Oasi-Research-Institute-IRCCS, Troina, Italy (F.Car.); Departments of Pharmacological and Biomolecular Sciences (F.Cal., G.R., M.A.R.) and Medical Biotechnology and Translational Medicine (R.M.), Università degli Studi di Milano, Milan, Italy; Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria (L.B., M.D., S.K.); Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy (C.F.); and School of Medicine, Universite' Libre de Bruxelles, Bruxelles, Belgium (J.M.)
| | - M Dold
- Departments of Drug Sciences (F.Car.) and Biomedical and Biotechnological Sciences, School of Medicine (G.M.L., F.D.), University of Catania, Catania, Italy; Oasi-Research-Institute-IRCCS, Troina, Italy (F.Car.); Departments of Pharmacological and Biomolecular Sciences (F.Cal., G.R., M.A.R.) and Medical Biotechnology and Translational Medicine (R.M.), Università degli Studi di Milano, Milan, Italy; Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria (L.B., M.D., S.K.); Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy (C.F.); and School of Medicine, Universite' Libre de Bruxelles, Bruxelles, Belgium (J.M.)
| | - G M Leggio
- Departments of Drug Sciences (F.Car.) and Biomedical and Biotechnological Sciences, School of Medicine (G.M.L., F.D.), University of Catania, Catania, Italy; Oasi-Research-Institute-IRCCS, Troina, Italy (F.Car.); Departments of Pharmacological and Biomolecular Sciences (F.Cal., G.R., M.A.R.) and Medical Biotechnology and Translational Medicine (R.M.), Università degli Studi di Milano, Milan, Italy; Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria (L.B., M.D., S.K.); Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy (C.F.); and School of Medicine, Universite' Libre de Bruxelles, Bruxelles, Belgium (J.M.)
| | - C Fabbri
- Departments of Drug Sciences (F.Car.) and Biomedical and Biotechnological Sciences, School of Medicine (G.M.L., F.D.), University of Catania, Catania, Italy; Oasi-Research-Institute-IRCCS, Troina, Italy (F.Car.); Departments of Pharmacological and Biomolecular Sciences (F.Cal., G.R., M.A.R.) and Medical Biotechnology and Translational Medicine (R.M.), Università degli Studi di Milano, Milan, Italy; Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria (L.B., M.D., S.K.); Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy (C.F.); and School of Medicine, Universite' Libre de Bruxelles, Bruxelles, Belgium (J.M.)
| | - J Mendlewicz
- Departments of Drug Sciences (F.Car.) and Biomedical and Biotechnological Sciences, School of Medicine (G.M.L., F.D.), University of Catania, Catania, Italy; Oasi-Research-Institute-IRCCS, Troina, Italy (F.Car.); Departments of Pharmacological and Biomolecular Sciences (F.Cal., G.R., M.A.R.) and Medical Biotechnology and Translational Medicine (R.M.), Università degli Studi di Milano, Milan, Italy; Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria (L.B., M.D., S.K.); Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy (C.F.); and School of Medicine, Universite' Libre de Bruxelles, Bruxelles, Belgium (J.M.)
| | - G Racagni
- Departments of Drug Sciences (F.Car.) and Biomedical and Biotechnological Sciences, School of Medicine (G.M.L., F.D.), University of Catania, Catania, Italy; Oasi-Research-Institute-IRCCS, Troina, Italy (F.Car.); Departments of Pharmacological and Biomolecular Sciences (F.Cal., G.R., M.A.R.) and Medical Biotechnology and Translational Medicine (R.M.), Università degli Studi di Milano, Milan, Italy; Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria (L.B., M.D., S.K.); Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy (C.F.); and School of Medicine, Universite' Libre de Bruxelles, Bruxelles, Belgium (J.M.)
| | - S Kasper
- Departments of Drug Sciences (F.Car.) and Biomedical and Biotechnological Sciences, School of Medicine (G.M.L., F.D.), University of Catania, Catania, Italy; Oasi-Research-Institute-IRCCS, Troina, Italy (F.Car.); Departments of Pharmacological and Biomolecular Sciences (F.Cal., G.R., M.A.R.) and Medical Biotechnology and Translational Medicine (R.M.), Università degli Studi di Milano, Milan, Italy; Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria (L.B., M.D., S.K.); Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy (C.F.); and School of Medicine, Universite' Libre de Bruxelles, Bruxelles, Belgium (J.M.)
| | - M A Riva
- Departments of Drug Sciences (F.Car.) and Biomedical and Biotechnological Sciences, School of Medicine (G.M.L., F.D.), University of Catania, Catania, Italy; Oasi-Research-Institute-IRCCS, Troina, Italy (F.Car.); Departments of Pharmacological and Biomolecular Sciences (F.Cal., G.R., M.A.R.) and Medical Biotechnology and Translational Medicine (R.M.), Università degli Studi di Milano, Milan, Italy; Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria (L.B., M.D., S.K.); Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy (C.F.); and School of Medicine, Universite' Libre de Bruxelles, Bruxelles, Belgium (J.M.)
| | - F Drago
- Departments of Drug Sciences (F.Car.) and Biomedical and Biotechnological Sciences, School of Medicine (G.M.L., F.D.), University of Catania, Catania, Italy; Oasi-Research-Institute-IRCCS, Troina, Italy (F.Car.); Departments of Pharmacological and Biomolecular Sciences (F.Cal., G.R., M.A.R.) and Medical Biotechnology and Translational Medicine (R.M.), Università degli Studi di Milano, Milan, Italy; Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria (L.B., M.D., S.K.); Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy (C.F.); and School of Medicine, Universite' Libre de Bruxelles, Bruxelles, Belgium (J.M.)
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Fabbri C, Giorgetti G, Del Dottore F, Dall’Ara D, Busca F, Casi M, Mattone V, Marchi G, Bartolini N, Sanniti S. 317. Administered activities and effective dose optimization in 18F-FDG PET/CT and 123I-MIBG SPECT/CT examinations in patients during oncology follow-up. Phys Med 2018. [DOI: 10.1016/j.ejmp.2018.04.326] [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: 11/26/2022] Open
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Bonica M, Goenaga S, Martin M, Feroci M, Luppo V, Fabbri C, Morales M, Micieli M, Enria D, Levis S. Vector competence of Argentinean Aedes aegypti population for different strains of Zika virus. Int J Infect Dis 2018. [DOI: 10.1016/j.ijid.2018.04.3859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Beccari M, Castiglione A, Cavaliere G, D'Aloya G, Fabbri C, Losi B, Ranzini C, Romagnoni G, Sorgato G. Unusual Case of Anuria Due to African Bee Stings. Int J Artif Organs 2018. [DOI: 10.1177/039139889201500505] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We describe a case of multiple African bee stings in which the exceptionally high dose suggests a direct effect of hymenoptera venom on the renal tubules. The case does not follow the previously reported pattern of hypovolemic or anaphylactic shock, hemolysis and/or rhabdomyolysis, despite the potentially lethal amount of venom injected
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Affiliation(s)
- M. Beccari
- Department of Nephrology and Dialysis Ospedale Fatebenefratelli e Oftalmico, Milano - Italy
| | - A. Castiglione
- Department of Nephrology and Dialysis Ospedale Fatebenefratelli e Oftalmico, Milano - Italy
| | - G. Cavaliere
- Department of Nephrology and Dialysis Ospedale Fatebenefratelli e Oftalmico, Milano - Italy
| | - G. D'Aloya
- Department of Nephrology and Dialysis Ospedale Fatebenefratelli e Oftalmico, Milano - Italy
| | - C. Fabbri
- Department of Nephrology and Dialysis Ospedale Fatebenefratelli e Oftalmico, Milano - Italy
| | - B. Losi
- Department of Nephrology and Dialysis Ospedale Fatebenefratelli e Oftalmico, Milano - Italy
| | - C. Ranzini
- Department of Immunohematology and Blood Transfusion, Ospedale Fatebenefratelli e Oftalmico, Milano - Italy
| | - G. Romagnoni
- Department of Nephrology and Dialysis Ospedale Fatebenefratelli e Oftalmico, Milano - Italy
| | - G. Sorgato
- Department of Nephrology and Dialysis Ospedale Fatebenefratelli e Oftalmico, Milano - Italy
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Angeli L, Legnaioli S, Fabbri C, Grifoni E, Lorenzetti G, Guilaine J, Palleschi V, Radi G. Analysis of Serra d'Alto figuline pottery (Matera, Italy): Characterization of the dark decorations using XRF. Microchem J 2018. [DOI: 10.1016/j.microc.2017.10.014] [Citation(s) in RCA: 7] [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] [Indexed: 10/18/2022]
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Radaelli F, Paggi S, Repici A, Gullotti G, Cesaro P, Rotondano G, Cugia L, Trovato C, Spada C, Fuccio L, Occhipinti P, Pace F, Fabbri C, Buda A, Manes G, Feliciangeli G, Manno M, Barresi L, Anderloni A, Dulbecco P, Rogai F, Amato A, Senore C, Hassan C. Barriers against split-dose bowel preparation for colonoscopy. Gut 2017; 66:1428-1433. [PMID: 27196589 DOI: 10.1136/gutjnl-2015-311049] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2015] [Revised: 03/14/2016] [Accepted: 03/19/2016] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Although split regimen is associated with higher adenoma detection and is recommended for elective colonoscopy, its adoption remains suboptimal. The identification of patient-related barriers may improve its implementation. Our aim was to assess patients' attitude towards split regimen and patient-related factors associated with its uptake. DESIGN In a multicentre, prospective study, outpatients undergoing colonoscopy from 8:00 to 14:00 were given written instructions for 4 L polyethylene glycol bowel preparation, offering the choice between split-dose and day-before regimens and emphasising the superiority of split regimen on colonoscopy outcomes. Uptake of split regimen and association with patient-related factors were explored by a 20-item questionnaire. RESULTS Of the 1447 patients (mean age 59.2±13.5 years, men 54.3%), 61.7% and 38.3% chose a split-dose and day-before regimens, respectively. A linear correlation was observed between time of colonoscopy appointments and split-dose uptake, from 27.3% in 8:00 patients to 96% in 14:00 patients (p<0.001, χ2 for linear trend). At multivariate analysis, colonoscopy appointment before 10:00 (OR 0.14, 95% CI 0.11 to 0.18), travel time to endoscopy service >1 h (OR 0.55, 95% CI 0.38 to 0.79), low education level (OR 0.72, 95% CI 0.54 to 0.96) and female gender (OR 0.74, 95% CI 0.58 to 0.95) were inversely correlated with the uptake of split-dose. Overall, the risk of travel interruption and faecal incontinence was slightly increased in split regimen patients (3.0% vs 1.4% and 1.5% vs 0.9%, respectively; p=NS). Split regimen was an independent predictor of adequate colon cleansing (OR 3.34, 95% CI 2.40 to 4.63) and polyp detection (OR 1.46, 95% CI 1.11 to 1.92). CONCLUSION Patient attitude towards split regimen is suboptimal, especially for early morning examinations. Interventions to improve patient compliance (ie, policies to reorganise colonoscopy timetable, educational initiatives for patient and healthcare providers) should be considered. TRIAL REGISTRATION NUMBER NCT02287051; pre-result.
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Affiliation(s)
- F Radaelli
- Department of Gastroenterology, Valduce Hospital, Como, Italy
| | - S Paggi
- Department of Gastroenterology, Valduce Hospital, Como, Italy
| | - A Repici
- Humanitas Research Hospital, Humanitas University, Rozzano, Milan, Italy
| | | | - P Cesaro
- Poliambulanza Foundation Hospital, Brescia, Italy
| | - G Rotondano
- Maresca Hospital, ASLNA3sud, Torre del Greco, Naples, Italy
| | - L Cugia
- SS Annunziata Hospital, Sassari, Italy
| | - C Trovato
- European Institute of Oncology, Milan, Italy
| | - C Spada
- Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy
| | - L Fuccio
- S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | | | - F Pace
- Bolognini Hospital, Seriate, Italy
| | - C Fabbri
- Bellaria-Maggiore Hospital, Bologna, Italy
| | - A Buda
- S. Maria del Prato Hospital, Feltre, Italy
| | - G Manes
- G. Salvini Hospital, Garbagnate Milanese, Milan, Italy
| | | | - M Manno
- Ospedali di Carpi e Mirandola, Modena, Italy
| | - L Barresi
- IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione), Palermo, Italy
| | - A Anderloni
- Humanitas Research Hospital, Humanitas University, Rozzano, Milan, Italy
| | | | - F Rogai
- University Hospital Careggi, Florence, Italy
| | - A Amato
- Department of Gastroenterology, Valduce Hospital, Como, Italy
| | - C Senore
- Centro di Prevenzione Oncologica (CPO Piemonte), AOU Città della Salute e della Scienza, Turin, Italy
| | - C Hassan
- Nuovo Regina Margherita Hospital, Rome, Italy
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Gibiino G, Fabbri C, Fagiuoli S, Ianiro G, Fornelli A, Cennamo V. Defining the biology of intrahepatic cholangiocarcinoma: molecular pathways and early detection of precursor lesions. Eur Rev Med Pharmacol Sci 2017; 21:730-741. [PMID: 28272710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Intrahepatic cholangiocarcinoma (ICC) is a rare malignant tumor of the biliary tract with growing incidence and dismal prognosis. It is responsible for 10-20% of primary liver cancer worldwide, but early diagnosis is still a challenge and few treatment options are available. Aim of this review is to summarize the current knowledge about biological features and arising molecular patterns of this disease. The identification of emerging biomarkers and early detection of precursor lesions shall play a key role in the perspective of future tailored targeted therapies.
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Affiliation(s)
- G Gibiino
- Medical Pathology, Department of Internal Medicine, Gastroenterology Division, Policlinico Universitario A. Gemelli, Catholic University of Sacred Heart, Rome, Italy.
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Sarti G, Fabbri C, Busca F, Del Dottore F, Sanniti S. Dosimetric treatment planning in nuclear medicine therapies. Phys Med 2016. [DOI: 10.1016/j.ejmp.2016.07.229] [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: 11/28/2022] Open
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Sessa A, Meroni M, Battini G, Volpi A, Conte F, Fabbri C, Serbelloni P, Spattini A, Giordano F. Glomerulonephritis in the elderly aged over 65. Clinicopathological analysis of 92 patients. Contrib Nephrol 2015; 105:85-92. [PMID: 8252877 DOI: 10.1159/000422475] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- A Sessa
- Unità Operativa di Nefrologia e Dialisi, Ospedale di Vimercate, Italia
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Fabbri C, Crisafulli C, Gurwitz D, Stingl J, Calati R, Albani D, Forloni G, Calabrò M, Martines R, Kasper S, Zohar J, Juven-Wetzler A, Souery D, Montgomery S, Mendlewicz J, Girolamo GD, Serretti A. Neuronal cell adhesion genes and antidepressant response in three independent samples. Pharmacogenomics J 2015; 15:538-48. [PMID: 25850031 DOI: 10.1038/tpj.2015.15] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Revised: 02/03/2015] [Accepted: 02/09/2015] [Indexed: 12/19/2022]
Abstract
Drug-effect phenotypes in human lymphoblastoid cell lines recently allowed to identify CHL1 (cell adhesion molecule with homology to L1CAM), GAP43 (growth-associated protein 43) and ITGB3 (integrin beta 3) as new candidates for involvement in the antidepressant effect. CHL1 and ITGB3 code for adhesion molecules, while GAP43 codes for a neuron-specific cytosolic protein expressed in neuronal growth cones; all the three gene products are involved in synaptic plasticity. Sixteen polymorphisms in these genes were genotyped in two samples (n=369 and 90) with diagnosis of major depressive episode who were treated with antidepressants in a naturalistic setting. Phenotypes were response, remission and treatment-resistant depression. Logistic regression including appropriate covariates was performed. Genes associated with outcomes were investigated in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) genome-wide study (n=1861) as both individual genes and through a pathway analysis (Reactome and String databases). Gene-based analysis suggested CHL1 rs4003413, GAP43 rs283393 and rs9860828, ITGB3 rs3809865 as the top candidates due to their replication across the largest original sample and the STAR*D cohort. GAP43 molecular pathway was associated with both response and remission in the STAR*D, with ELAVL4 representing the gene with the highest percentage of single nucleotide polymorphisms (SNPs) associated with outcomes. Other promising genes emerging from the pathway analysis were ITGB1 and NRP1. The present study was the first to analyze cell adhesion genes and their molecular pathways in antidepressant response. Genes and biomarkers involved in neuronal adhesion should be considered by further studies aimed to identify predictors of antidepressant response.
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Affiliation(s)
- C Fabbri
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy
| | - C Crisafulli
- Department of Biomedical Science and Morphological and Functional Images, University of Messina, Messina, Italy
| | - D Gurwitz
- Department of Human Molecular Genetics and Biochemistry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Italy
| | - J Stingl
- Federal Institute for Drugs and Medical Devices, University Bonn Medical School, Bonn, Germany
| | - R Calati
- Faculty Centre for Translational Medicine, University Bonn, Medical Faculty, Bonn, Germany
| | - D Albani
- Laboratory of Biology of Neurodegenerative Disorders, Department of Neuroscience, IRCCS Istituto di Ricerche Farmacologiche 'Mario Negri', Milan, Italy
| | - G Forloni
- Laboratory of Biology of Neurodegenerative Disorders, Department of Neuroscience, IRCCS Istituto di Ricerche Farmacologiche 'Mario Negri', Milan, Italy
| | - M Calabrò
- Department of Biomedical Science and Morphological and Functional Images, University of Messina, Messina, Italy.,Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - R Martines
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy.,Laboratory of Biology of Neurodegenerative Disorders, Department of Neuroscience, IRCCS Istituto di Ricerche Farmacologiche 'Mario Negri', Milan, Italy
| | - S Kasper
- Department of Psychiatry and Psychotherapy, Medical University Vienna, Vienna, Austria
| | - J Zohar
- Department of Psychiatry, Sheba Medical Center, Tel Hashomer and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - A Juven-Wetzler
- Department of Psychiatry, Sheba Medical Center, Tel Hashomer and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - D Souery
- Laboratoire de Psychologie Medicale, Universitè Libre de Bruxelles and Psy Pluriel, Centre Européen de Psychologie Medicale, Brussels, Belgium
| | | | - J Mendlewicz
- Université Libre de Bruxelles, Brussels, Belgium
| | - G D Girolamo
- Faculty Centre for Translational Medicine, University Bonn, Medical Faculty, Bonn, Germany
| | - A Serretti
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy
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Laghi A, Bellini D, Petrozza V, Piccazzo R, Santoro GA, Fabbri C, van der Paardt MP, Stoker J. Imaging of colorectal polyps and early rectal cancer. Colorectal Dis 2015; 17 Suppl 1:36-43. [PMID: 25511860 DOI: 10.1111/codi.12820] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- A Laghi
- Department of Radiological Sciences, Oncology and Pathology, "SAPIENZA" University of Rome, I.C.O.T. Hospital, Latina, Italy
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Chieregato A, Paci G, Portolani L, Ravaldini M, Fabbri C, Martino C, Russo E, Simini B. Satisfaction of patients' next of kin in a 'Hub & Spoke' ICU network. Anaesthesia 2014; 69:1117-26. [PMID: 25204238 DOI: 10.1111/anae.12806] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2014] [Indexed: 11/29/2022]
Abstract
This study aimed to gauge the opinions of patients' next of kin regarding transfer of patients from the specialist 'Hub' intensive care unit, to 'Spoke' intensive care units near home. We included 213 consecutive patients with severe trauma or severe acute neurological conditions admitted to the Hub intensive care unit over a 21-month period, who were repatriated to Spoke intensive care units for ongoing intensive care. One year after admission to the Hub intensive care unit, two thirds of patients' next of kin said they would have preferred patients to have been treated only in the Hub intensive care unit, and not repatriated. They perceived Hub intensive care unit care to be important, and would have preferred that their relatives be hospitalised there until intensive treatment was completed. The next of kin's preference was associated with severe acute neurological conditions (p ≤ 0.0001). Although centralised Hub & Spoke intensive care unit networks are appropriate to ensure specialised care, repatriation to local hospitals may not be appropriate for patients with severe neurological conditions.
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Affiliation(s)
- A Chieregato
- Anaesthesia and Intensive Care Unit, AOU Careggi, Florence, Italy
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Bassi M, Luigiano C, Fabbri C, Ferrara F, Ghersi S, Alibrandi A, Fuccio L, Virgilio C, Patelli M, Zanello M, Cennamo V. Large diameter fully covered self-expanding metal stent placement for palliation of proximal malignant esophageal strictures. Dis Esophagus 2014; 28:579-84. [PMID: 24827641 DOI: 10.1111/dote.12236] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [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] [Indexed: 02/06/2023]
Abstract
In patients with malignant esophageal strictures within 6 cm from the upper esophageal sphincter, self-expanding metal stents placement represents a challenge because there is an increased risk of complications. The aim of this study was to assess the safety and effectiveness of large-diameter WallFlex(®) fully covered self-expanding metal stents for palliation of patients with proximal malignant esophageal strictures. From March 2010 to December 2012, 12 patients with proximal strictures (4-6 cm from the upper esophageal sphincter) and six with very proximal strictures (<4 cm from the upper esophageal sphincter) were palliated with this fully covered self-expanding metal stent and included in the study. Technical success was 100% and clinical success was 94%. The mean baseline dysphagia score was 3.2, and 1 week after stenting it improved significantly to 1.3 (P < 0.001). Early complications occurred in four patients, more frequently in patients with very proximal strictures as compared with patients with proximal strictures (P = 0.02). Late complications occurred in five patients, and there were no differences between patients with very proximal strictures or proximal strictures (P = 0.245). The mean survival after stent placement was 119 days, and no differences between patients with very proximal strictures versus proximal strictures were found (P = 0.851). There was no stent-related mortality or 30-day mortality. Our results suggested that a large-diameter fully covered self-expanding metal stent is an effective and secure device for palliation of patients with proximal malignant esophageal strictures.
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Affiliation(s)
- M Bassi
- Unit of Gastroenterology and Digestive Endoscopy, AUSL Bologna, Bologna, Italy
| | - C Luigiano
- Unit of Gastroenterology and Digestive Endoscopy, ARNAS Garibaldi, Catania, Italy
| | - C Fabbri
- Unit of Gastroenterology and Digestive Endoscopy, AUSL Bologna, Bologna, Italy
| | - F Ferrara
- Unit of Gastroenterology and Digestive Endoscopy, AUSL Bologna, Bologna, Italy
| | - S Ghersi
- Unit of Gastroenterology and Digestive Endoscopy, AUSL Bologna, Bologna, Italy
| | - A Alibrandi
- Department of Statistics, University of Messina, Messina, Italy
| | - L Fuccio
- Department of Clinical Medicine, S. Orsola-Malpighi University Hospital, Bologna, Italy
| | - C Virgilio
- Unit of Gastroenterology and Digestive Endoscopy, ARNAS Garibaldi, Catania, Italy
| | - M Patelli
- Thoracic Endoscopy and Pulmonology Unit, Maggiore Hospital, Bologna, Italy
| | - M Zanello
- Anesthesia and Intensive Care, IRCCS Istituto delle Scienze Neurologiche Bellaria Hospital, Bologna, Italy
| | - V Cennamo
- Unit of Gastroenterology and Digestive Endoscopy, AUSL Bologna, Bologna, Italy
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Luigiano C, Togliani T, Cennamo V, Maimone A, Polifemo AM, Pilati S, Fabbri C. Transrectal endoscopic ultrasound-guided drainage of pelvic abscess with placement of a fully covered self-expandable metal stent. Endoscopy 2014; 45 Suppl 2 UCTN:E245-6. [PMID: 24008447 DOI: 10.1055/s-0032-1326250] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- C Luigiano
- Unit of Gastroenterology and Digestive Endoscopy, AUSL Bologna Bellaria-Maggiore Hospital, Bologna, Italy.
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Tortoli E, Dionisio D, Fabbri C. Evaluation of Moxifloxacin ActivityIn VitroAgainstMycobacterium tuberculosis, Including Resistant and Multidrug-Resistant Strains. J Chemother 2013; 16:334-6. [PMID: 15332706 DOI: 10.1179/joc.2004.16.4.334] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
The new quinolone moxifloxacin was tested against 86 strains of Mycobacterium tuberculosis including 13 resistant and 4 multiresistant strains. The antimicrobial susceptibility was tested, in parallel, using two different liquid media, the radiometric Bactec 12B and the Mycobacteria Growth Indicator Tube (Becton Dickinson, USA). All strains but two were susceptible at 0.5 microg/ml of moxifloxacin; for the remaining two strains, both multidrugresistant, the minimal inhibitory concentrations (MIC) were =2 and >4 microg/ml respectively. Our data confirm the high antitubercular in vitro activity of moxifloxacin.
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Affiliation(s)
- E Tortoli
- Centro Regionale di Riferimento per la Diagnostica dei Micobatteri, Laboratorio di Microbiologia e Virologia, Ospedale di Careggi, Florence, Italy.
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Larghi A, Panic N, Capurso G, Leoncini E, Arzani D, Salvia R, Del Chiaro M, Frulloni L, Arcidiacono PG, Zerbi A, Manta R, Fabbri C, Ventrucci M, Tarantino I, Piciucchi M, Carnuccio A, Boggi U, Costamagna G, Delle Fave G, Pezzilli R, Bassi C, Bulajic M, Ricciardi W, Boccia S. Prevalence and risk factors of extrapancreatic malignancies in a large cohort of patients with intraductal papillary mucinous neoplasm (IPMN) of the pancreas. Ann Oncol 2013; 24:1907-1911. [PMID: 23676419 DOI: 10.1093/annonc/mdt184] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [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] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The objectives of this study are to estimate prevalence and incidence of extrapancreatic malignancies (EPMs) among intraductal papillary mucinous neoplasms (IPMNs) of the pancreas, and to identify risk factors for their occurrence. PATIENTS AND METHODS We conducted multicentric cohort study in Italy from January 2010 to January 2011 including 390 IPMN cases. EPMs were grouped as previous, synchronous (both prevalent) and metachronous (incident). We calculated the observed/expected (O/E) ratio of prevalent EPMs, and compared the distribution of demographic, medical history and lifestyle habits. RESULTS Ninety-seven EPMs were diagnosed in 92 patients (23.6%), among them 78 (80.4%) were previous, 14 (14.4%) were synchronous and 5 (5.2%) were metachronous. O/E ratios for prevalent EPMs were significantly increased for colorectal carcinoma (2.26; CI 95% 1.17-3.96), renal cell carcinoma (6.00; CI 95% 2.74-11.39) and thyroid carcinoma (5.56; CI 95% 1.80-12.96). Increased age, heavy cigarette smoking, alcohol consumption and first-degree family history of gastric cancer are significant risk factors for EPMs, while first-degree family history of colorectal carcinoma was borderline. CONCLUSION We report an increased prevalence of EPMs in Italian patients with IPMN, especially for colorectal carcinoma, renal cell and thyroid cancers. A systematic surveillance of IPMN cases for such cancer types would be advised.
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Affiliation(s)
| | - N Panic
- Department of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy; Faculty of Medicine, University of Belgrade, Belgrade; University Clinical-Hospital Center 'Dr Dragisa Misovic-Dedinje', Belgrade, Serbia
| | - G Capurso
- Digestive and Liver Disease Unit, University 'Sapienza', Rome
| | - E Leoncini
- Department of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - D Arzani
- Department of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - R Salvia
- Department of Surgery, University of Verona, Verona
| | | | - L Frulloni
- Department of Gastroenterology, University of Verona, Verona
| | - P G Arcidiacono
- Department of Gastroenterology & Gastrointestinal Endoscopy, San Raffaele Hospital, Milano
| | - A Zerbi
- Pancreatic Surgery Section, Istituto Humanitas, Milano
| | - R Manta
- Department of Gastroenterology, S. Agostino Hospital, Modena
| | - C Fabbri
- Department of Gastroenterology, Bellaria Maggiore Hospita, Bologna
| | - M Ventrucci
- Department of Internal Medicine, University of Bologna, Bologna
| | | | - M Piciucchi
- Digestive and Liver Disease Unit, University 'Sapienza', Rome
| | | | - U Boggi
- Department of Surgery, University of Pisa, Pisa
| | | | - G Delle Fave
- Digestive and Liver Disease Unit, University 'Sapienza', Rome
| | - R Pezzilli
- Department of Internal Medicine, University of Bologna, Bologna
| | - C Bassi
- Department of Surgery, University of Verona, Verona
| | - M Bulajic
- Faculty of Medicine, University of Belgrade, Belgrade; University Clinical-Hospital Center 'Dr Dragisa Misovic-Dedinje', Belgrade, Serbia; Department of Gastroenterology, University Clinical Hospital 'Santa Maria della Misericordia', Udine
| | - W Ricciardi
- Department of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - S Boccia
- Department of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy; IRCCS San Raffaele Pisana, Rome, Italy.
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Luigiano C, Ferrara F, Miraglia S, Favara C, Fabbri C, La Ferrera G, Virgilio C. Conservative management of a late rectal perforation following cold biopsy polypectomy. Endoscopy 2013; 44 Suppl 2 UCTN:E430. [PMID: 23258488 DOI: 10.1055/s-0032-1325859] [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] [Indexed: 12/10/2022]
Affiliation(s)
- C Luigiano
- Unit of Gastroenterology and Digestive Endoscopy, ARNAS Garibaldi, Via Palermo 636, Catania, Italy.
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Fabbri C, Mattone V, Casi M, De Lauro F, Agostini M, Bartolini N, D'arienzo M, Marchi G, Bartolomei M, Sarti G. Quantitative evaluation on [⁹⁰Y] DOTATOC PET and SPECT imaging by phantom acquisitions and clinical applications in locoregional and systemic treatments. Q J Nucl Med Mol Imaging 2012; 56:522-528. [PMID: 23358405] [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
AIM The aim of this paper was to compare [⁹⁰Y]-PET and SPECT imaging quantification for dosimetric applications in targeted radionuclide therapy. METHODS Imaging studies were carried out by SPECT-CT and PET equipment performing phantom tests first. [⁹⁰Y]-SPECT and PET scans were compared in terms of sensitivity, minimum detectable activity concentration, recovery coefficients (RCs) and system spatial resolution (FWHM). Quantitative evaluations by PET and SPECT acquisitions were then assessed in patients who received therapeutic activity of [⁹⁰Y]-DOTATOC directly injected into the surgical cavity by locoregional route in glioma treatment and by systemic route in neuroendocrine tumour patients who underwent intravenous infusion. Finally 3D-dose distributions by SPECT and PET images were obtained. RESULTS Sensitivity was proven to be about fivefold higher for SPECT than for PET. To obtain a good-quality PET imaging, the minimum detectable activity concentration was determined to be equal to 1 MBq/mL compared with 0.05 MBq/mL that was sufficient to assess adequate SPECT imaging. RCs were 100% for volume ≥ 25.5 mL for PET and ≥ 110 mL for SPECT. FWHM was 7 mm for PET and 19 mm for SPECT scans. With regard to locoregional therapy, excellent imaging was obtained with both PET and SPECT. On the contrary, systemic administration did not permit us to obtain suitable PET imaging. PET and SPECT images were affected by considerable noise, whose influence is much more important in the quantitative evaluation of dose volume histograms rather than in the visual interpretation of images. CONCLUSION [⁹⁰Y]-activity quantification is feasible by SPECT and PET imaging. For clinical applications, SPECT-CT is the best technique for visualizing the radiopharmaceuticals following systemic infusion, while both SPECT and PET scans are effective in analyzing locoregional distribution. Nevertheless PET study demonstrates the best spatial definition.
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Affiliation(s)
- C Fabbri
- Medical Physics Unit, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori Meldola, Forlì Cesena, Italy.
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Fabbri C, Luigiano C, Cennamo V, Polifemo AM, Maimone A, Jovine E, D'Imperio N, Zanello M. The Gastro-Laryngeal Tube for interventional endoscopic biliopancreatic procedures in anesthetized patients. Endoscopy 2012; 44:1051-4. [PMID: 22983834 DOI: 10.1055/s-0032-1310159] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [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: 12/14/2022]
Abstract
The Gastro-Laryngeal Tube (G-LT) is a modification of the laryngeal tube which provides a dedicated channel for the insertion of an endoscope while acting as a supraglottic airway for ventilation. The aim of this study was to assess the safety and effectiveness of this device in patients undergoing anesthesia for interventional endoscopic biliopancreatic procedures (IEBPPs).A total of 22 patients were included in the study. The G-LT was inserted successfully in all patients. Arterial oxygen saturation was stable; the mean value was 97.9%. The IEBPPs were performed successfully in all patients through the endoscopic channel, with a mean duration of 99 minutes. The maneuverability of the endoscope was considered good in all patients. There were two cases of sore throat after the procedures, two cases of asymptomatic erosion of the upper esophageal mucosa, one case of Mallory-Weiss syndrome, and one case of pancreatitis after endoscopic retrograde cholangiopancreatography.Our results suggest that the G-LT is an effective and secure device for airway management and for use during IEBPPs.
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Affiliation(s)
- C Fabbri
- Unit of Gastroenterology and Digestive Endoscopy, AUSL Bologna Bellaria-Maggiore Hospital, Bologna, Italy.
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Franceschini G, Terribile D, Magno S, Fabbri C, Accetta C, Di Leone A, Moschella F, Barbarino R, Scaldaferri A, Darchi S, Carvelli ME, Bove S, Masetti R. Update on oncoplastic breast surgery. Eur Rev Med Pharmacol Sci 2012; 16:1530-1540. [PMID: 23111966] [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
Oncoplastic surgery of the breast (OPS) has generated great excitement over the past years and has become an integrated component of the surgical treatment of breast cancer. Oncoplastic surgical procedures associate the best surgical oncologic principles to achieve wide tumor-free margins with the best principles of plastic surgery to optimize cosmetic outcomes. Thanks to oncoplastic techniques, the role of breast conserving surgery (BCS) has been extended to include a group of patients who would otherwise require mastectomy to achieve adequate tumor clearance. As OPS continues to gain acceptance and diffusion, an optimal and systematic approach to these techniques is becoming increasingly necessary. This article has the aim to review the essential principles and techniques associated with oncoplastic surgery, based on the data acquired through an extensive search of the PUBMED and MEDLINE database for articles published using the key words "breast cancer oncoplastic surgery". This review analyzes possible the advantages", classifications, indications, and the criteria for a proper selection of oncoplastic techniques to facilitate one's ability to master these procedures and make OPS a safe and an effective procedure.
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Affiliation(s)
- G Franceschini
- Department of Surgery, Catholic University of the Sacred Heart, Rome, Italy.
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Cennamo V, Luigiano C, Fabbri C, Maimone A, Bazzoli F, Ceroni L, Morace C, Jovine E. Cholangioscopy using a new type of cholangioscope for the diagnosis of biliary tract disease: a case series. Endoscopy 2012; 44:878-81. [PMID: 22814962 DOI: 10.1055/s-0032-1310016] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
We present an initial report regarding the clinical usefulness of peroral cholangioscopy, using a new type of cholangioscope, the Polyscope. Peroral cholangioscopy was performed in four patients with strictures after orthotopic liver transplantation (OLT) which were suspected of being ischemic biliary lesions, in three with indeterminate biliary strictures, in three with suspected retained bile duct stones, and in two for evaluation of the intraductal spread of adenomatous tissue after an ampullectomy. In all cases peroral cholangioscopy was performed successfully without complications. On the basis of direct viewing and/or tissue sampling a correct diagnosis was reached in all cases: in all patients who underwent OLT the strictures were not ischemic; the indeterminate strictures were all benign; and, in patients with suspected stones, complete clearance was confirmed. Intraductal spread was confirmed in one patient and excluded in the other. In our experience, peroral cholangioscopy using a Polyscope is a safe and effective method for diagnosing bile duct lesions.
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Affiliation(s)
- V Cennamo
- Unit of Digestive Endoscopy, Department of Surgery, AUSL Bologna Bellaria Hospital, Bologna, Italy.
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Franceschini G, Visconti G, Terribile D, Fabbri C, Magno S, Di Leone A, Salgarello M, Masetti R. The role of oxidized regenerate cellulose to prevent cosmetic defects in oncoplastic breast surgery. Eur Rev Med Pharmacol Sci 2012; 16:966-971. [PMID: 22953647] [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 Breast conserving surgery (BCS) combined with postoperative radiotherapy has become the gold standard of locoregional treatment for the majority of patients with early-stage breast cancer, offering equivalent survival and improved body image and lifestyle scores as compared to mastectomy. In an attempt to optimize the oncologic safety and cosmetic results of BCS, oncoplastic procedures (OPP) have been introduced in recent years combining the best principles of surgical oncology with those of plastic surgery. However, even with the use of OPP, cosmetic outcomes may result unsatisfying when a large volume of parenchyma has to be removed, particularly in small-medium size breasts. AIM The aim of this article is to report our preliminary results with the use of oxidized regenerate cellulose (ORC) (Tabotamp fibrillar, Johnson & Johnson; Ethicon, USA) as an agent to prevent cosmetic defects in patients undergoing OPP for breast cancer and to analyze the technical refinements that can enhance its efficacy in optimizing cosmetic defects. METHODS Different OPP are selected based on the location and size of the tumor as well as volume and shape of the breast. After excision of the tumor, glandular flaps are created by dissection of the residual parenchyma from the pectoralis and serratus muscles and from the skin. After careful haemostasis, five layers of ORC are positioned on the pectoralis major in the residual cavity and covered by advancement of the glandular flaps. Two additional layers of ORC are positioned above the flaps and covered by cutaneous-subcutaenous flaps. RESULTS The use of ORC after OPP has shown promising preliminary results, indicating a good tolerability and positive effects on cosmesis. CONCLUSIONS This simple and reliable surgical technique may allow not only to reduce the rate of post-operative bleeding and infection at the surgical site but also to improve cosmetic results.
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Affiliation(s)
- G Franceschini
- Multidisciplinary Breast Center, School of Medicine,Catholic University of the "Sacred Heart", Rome, Italy.
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Fabbri C, Luigiano C, Cennamo V, Polifemo AM, Barresi L, Jovine E, Traina M, D'Imperio N, Tarantino I. Endoscopic ultrasound-guided transmural drainage of infected pancreatic fluid collections with placement of covered self-expanding metal stents: a case series. Endoscopy 2012; 44:429-33. [PMID: 22382852 DOI: 10.1055/s-0031-1291624] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Endoscopic ultrasound-guided transmural drainage (EUS-GTD) has become the standard procedure for treating symptomatic pancreatic fluid collections. The aim of this series was to evaluate the efficacy and safety of covered self-expanding metal stent (CSEMS) placement for treating infected pancreatic fluid collections. From January 2007 to May 2010, 22 patients (18 M/4F; mean age 56.9) with infected pancreatic fluid collections (mean size, 13.2 cm) at two Italian centers were evaluated for EUS-GTD. In 20 of the 22 patients, EUS-GTD with CSEMS placement was indicated. Early complications occurred in two patients: one patient developed a superinfection, which was managed conservatively, and one experienced stent migration and superinfection, and was managed surgically. The CSEMSs were removed without difficulty in 18 patients after a median of 26 days, while stent removal failed in one patient due to inflammatory tissue ingrowth; instead it was removed during surgery performed for renal cancer. Clinical success was achieved without additional intervention in 17 patients during a mean follow-up of 610 days; only one symptomatic recurrence was observed. In our experience, EUS-GTD with CSEMS placement appears safe for the treatment of infected pancreatic fluid collections.
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Affiliation(s)
- C Fabbri
- Unit of Gastroenterology and Digestive Endoscopy, AUSL Bologna Bellaria-Maggiore Hospital, Bologna, Italy.
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Luigiano C, Ferrara F, Pellicano R, Fabbri C, Bassi M, Cennamo V, Ghersi S, Morace C, Consolo P, Billi P, Polifemo AM, D'Imperio N. Short- and long-term outcomes of self-expanding metal stent placement as a bridge to surgery for acute left-sided colorectal cancer obstruction. MINERVA CHIR 2011; 66:501-508. [PMID: 22233656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
AIM The aim of this study was to evaluate the short- and long-term outcomes of self-expanding metal stent (SEMS) insertion as a bridge to surgery (BTS) in patients presenting with acute left-sided colorectal cancer obstruction (LCCO). METHODS All patients with acute LCCO who underwent endoscopic SEMS placement as a BTS between January 2005 and December 2010 were reviewed and included in the study. RESULTS Thirty-six patients (19M and 17F; mean age 68.5) were included. The most frequent location was the sigmoid colon (47.2%). Technical success was achieved in 91.6% and clinical success in 88.9%. Technical failure was related to the location of the stricture at the rectosigmoid junction (P=0.03). There were four SEMS-related complications: one fecal obstruction, one haemorrhage treated with APC and two silent perforations which were noted during surgical resection. The mean time between SEMS insertion and surgical treatment was 19 days (range 6-80 days) and the most frequent intervention was a left hemicolectomy (46.9%). No intraoperative mortality and morbidity, or postoperative mortality were observed. The postoperative morbidity rate was 18.8% (two wound infections, one deep venous thrombosis, one case of pneumonia and one anastomotic dehiscence). Finally, after discharge from hospital, a total of 29 patients (90%) were stoma free. At the end of the follow-up period, 24 patients are still alive and the mean survival rate was 37.3±18 months (range 9-72). CONCLUSION In our experience, SEMS placement as a BTS is a safe and effective strategy for the treatment of patients with acute LCCO.
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Affiliation(s)
- C Luigiano
- Unit of Gastroenterology and Digestive Endoscopy, AUSL Bologna, Bellaria-Maggiore Hospital, Bologna, Italy.
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Blom D, Fabbri C, Connor EC, Schiestl FP, Klauser DR, Boller T, Eberl L, Weisskopf L. Production of plant growth modulating volatiles is widespread among rhizosphere bacteria and strongly depends on culture conditions. Environ Microbiol 2011; 13:3047-58. [PMID: 21933319 DOI: 10.1111/j.1462-2920.2011.02582.x] [Citation(s) in RCA: 204] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Recent studies have suggested that bacterial volatiles play an important role in bacterial-plant interactions. However, few reports of bacterial species that produce plant growth modulating volatiles have been published, raising the question whether this is just an anecdotal phenomenon. To address this question, we performed a large screen of strains originating from the soil for volatile-mediated effects on Arabidopsis thaliana. All of the 42 strains tested showed significant volatile-mediated plant growth modulation, with effects ranging from plant death to a sixfold increase in plant biomass. The effects of bacterial volatiles were highly dependent on the cultivation medium and the inoculum quantity. GC-MS analysis of the tested strains revealed over 130 bacterial volatile compounds. Indole, 1-hexanol and pentadecane were selected for further studies because they appeared to promote plant growth. None of these compounds triggered a typical defence response, using production of ethylene and of reactive oxygen species (ROS) as read-outs. However, when plants were challenged with the flg-22 epitope of bacterial flagellin, a prototypical elicitor of defence responses, additional exposure to the volatiles reduced the flg-22-induced production of ethylene and ROS in a dose-dependent manner, suggesting that bacterial volatiles may act as effectors to inhibit the plant's defence response.
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Affiliation(s)
- D Blom
- Department of Microbiology, Institute of Plant Biology, University of Zurich, Zurich, Switzerland
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Luigiano C, Ferrara F, Fabbri C, Bassi M, Cennamo V, D'Imperio N. Insertion of two overlapping new covered metal stents for closure of a complex biliary leak and description of a safe technique for their removal. Endoscopy 2011; 43 Suppl 2 UCTN:E211-2. [PMID: 21590609 DOI: 10.1055/s-0030-1256394] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- C Luigiano
- Unit of Gastroenterology and Digestive Endoscopy, AUSL Bologna Bellaria-Maggiore Hospital, Bologna, Italy.
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Porcelli S, Drago A, Fabbri C, Serretti A. Mechanisms of antidepressant action: an integrated dopaminergic perspective. Prog Neuropsychopharmacol Biol Psychiatry 2011; 35:1532-43. [PMID: 21402119 DOI: 10.1016/j.pnpbp.2011.03.005] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2010] [Revised: 02/23/2011] [Accepted: 03/08/2011] [Indexed: 10/18/2022]
Abstract
The molecular mechanisms that cause and maintain the major depressive disorder (MDD) are currently unknown. Consistently, antidepressant treatments are characterized by insufficient success rates. This causes high social costs and severe personal sufferings. In the present review we analyze some of the paradigms that are used to explain MDD, particularly from the perspective of the dopaminergic (DA) system. DA has been more classically associated with psychosis and substance abuse disorders, even though a role of DA in MDD has been proposed as well and some antidepressants with DA profile exist. In the present work, we review some of the molecular mechanisms that underpin MDD from the perspective of the dopaminergic system, in the hope of unifying some of the major theories of MDD - the monoaminergic, inflammatory, epigenetics, neurotrophin and anti-apoptotic theories. Several shared components of these theories are highlighted, partially accounted by the functions of the DA system (see supplementary video).
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Affiliation(s)
- S Porcelli
- Institute of Psychiatry, University of Bologna, Viale Carlo Pepoli 5, 40123 Bologna, Italy.
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Luigiano C, Ferrara F, Pellicano R, Fabbri C, Cennamo V, Bassi M, Ghersi S, Billi P, Polifemo A, Festa C, Cerchiari E, Morace C, Consolo P, Alibrandi A, D'Imperio N. Carbon dioxide insufflation versus air insufflation during endoscopic retrograde cholangiopancreatography under general anesthesia. Minerva Med 2011; 102:261-269. [PMID: 21959700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
AIM The aim of this paper was to evaluate the effect of carbon dioxide (CO2) vs. air insufflation on post-endoscopic retrograde cholangiopancreatography (ERCP) abdominal pain and distension. In addition, we investigated the changes in the partial pressure of end-tidal CO2 (PetCO2) and the partial pressure of arterial CO2 (PaCO2). METHODS From October 2009 to January 2010, all patients admitted to our centre for ERCP were screened for enrollment; the patients recruited were randomised to CO2 or air insufflation. The patients were asked to rate their abdominal pain intensity and distension using a 100-mm Visual Analogue Scale (VAS) before, in the recovery room and at 1, 3, 6 and 24 hours after the ERCP. All anesthesiological and endoscopic details and complications were evaluated. RESULTS We included 76 patients, 39 in the Air group and 37 in the CO2 group. The groups were similar for age, gender, indications and duration of the procedure. Post-procedure mean values of pain (in the recovery room and at 1, 3 and 6 hours) and distension (at recovery room, and at 1 and 3 hours) according to the VAS were significantly reduced in the CO2 group as compared to the Air group. At baseline, the PetCO2 values were similar between the two groups while, during the ERCP, they increased significantly in CO2 group as compared to the Air group; these values were reduced by simply increasing the ventilation. CONCLUSION CO2 insufflation during ERCP significantly reduces post-procedural abdominal pain and distension. Increased PetCO2 and PaCO2 values remained within acceptable or readily controllable ranges.
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Affiliation(s)
- C Luigiano
- AUSL Bologna Bellaria-Maggiore Hospital, Bologna, Italy.
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Cennamo V, Morace C, Ceroni L, Fabbri C. On the efficacy of penicillins for Helicobacter pylori eradication. Panminerva Med 2011; 53:137. [PMID: 21659978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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Fabbri C, Luigiano C, Cennamo V, Ferrara F, Pellicano R, Polifemo AM, Tarantino I, Barresi L, Morace C, Consolo P, D'Imperio N. Complications of endoscopic ultrasonography. MINERVA GASTROENTERO 2011; 57:159-166. [PMID: 21587145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Since its development in the 1980s, endoscopic ultrasonography (EUS) has undergone a great deal of technological modifications. EUS has become an important tool in the evaluation of patients with various clinical disorders and is increasingly being utilized in many centers. EUS has been evolving over the years; EUS-guided fine needle aspiration (FNA) for cytological and/or histological diagnosis has become standard practice and a wide array of interventional and therapeutic procedures are performed under EUS guidance for diseases which otherwise would have needed surgery, with its associated morbidities. EUS shares the risks and complications of other endoscopic procedures. This article addresses the specific adverse effects and risks associated with EUS, EUS-FNA and interventional EUS, namely perforation, bleeding, pancreatitis and infection. Measures to help minimizing these risks will also be discussed.
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Affiliation(s)
- C Fabbri
- Unit of Gastroenterology and Digestive Endoscopy, AUSL Bologna, Bellaria-Maggiore Hospital, Bologna, Italy
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Fabbri C, Luigiano C, Fuccio L, Polifemo AM, Ferrara F, Ghersi S, Bassi M, Billi P, Maimone A, Cennamo V, Masetti M, Jovine E, D'Imperio N. EUS-guided biliary drainage with placement of a new partially covered biliary stent for palliation of malignant biliary obstruction: a case series. Endoscopy 2011; 43:438-41. [PMID: 21271507 DOI: 10.1055/s-0030-1256097] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [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: 12/11/2022]
Abstract
Endoscopic ultrasonography-guided biliary drainage (EUS-BD) has been developed as an alternative drainage technique in patients with obstructive jaundice where endoscopic retrograde cholangiopancreatography (ERCP) has failed. Between July 2008 and December 2009, 16 patients (9 men; median age 79 years) with biliopancreatic malignancy, who were candidates for alternative techniques of biliary decompression because ERCP had been unsuccessful, underwent EUS-BD with placement of a transmural or transpapillary partially covered nitinol self-expandable metal stent (SEMS). EUS-assisted cholangiography was successful in all patients, with definition of the relevant anatomy, but biliary drainage was successfully performed in only 12 (75 %) of the 16 patients (9 choledochoduodenostomies with SEMS placement and 3 biliary rendezvous procedures with papillary SEMS placement), with regression of the cholestasis. No major complications and no procedure-related deaths occurred. There was one case of pneumoperitoneum which was managed conservatively. The median follow-up was 170 days. During the follow-up, eight patients of the 12 patients in whom biliary draining was successful died; four are currently alive. None of the patients required endoscopic reintervention. This series demonstrated that EUS-BD with a partially covered SEMS has a high rate of clinical success and low complication rates, and could represent an alternative choice for biliary decompression.
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Affiliation(s)
- C Fabbri
- Unit of Gastroenterology and Digestive Endoscopy, AUSL Bologna Bellaria-Maggiore Hospital, Largo Nigrisoli 2, Bologna, Italy.
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Sarti G, Del Dottore F, Fabbri C, Tassinari L, Pagan S, Rustignoli M, Motta P. Individual monitoring in nuclear medicine therapeutic procedures using extremity dosemeters LiF(Mg, Cu, P). Radiat Prot Dosimetry 2011; 144:521-524. [PMID: 21030398 DOI: 10.1093/rpd/ncq331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Unsealed beta-gamma-emitting sources are used (15 GBq (90)Y each session) in nuclear medicine therapeutic procedures. Inside the manipulation cell and while giving the injection to the patient, the skin exposure is very high; electron radiation field is not homogeneous and thus the exposure of the extremities is not uniform. Particular individual monitoring is adopted: single thermoluminescence dosemeter, wrapped in polyethylene film and placed on an adhesive tape, is positioned on the tip of the fingers; 6-10 dosemeters are assigned to each operator per session. The energy and angle response is studied for X-ray spectra, (90)Sr/Y and (204)Tl--a unique mean calibration factor is calculated in order to estimate H(p)(0.07). Performance of dosemeter is analysed according to ISO 62387-1(2007) and the combined uncertainty (calculated using the Monte Carlo method) results lie in the order of 11 %. This method reveals the critical step of manipulation and administration and ensures that dose limits are not exceeded.
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Affiliation(s)
- G Sarti
- Division of Medical Physics, Bufalini Hospital, Via Ghirotti 286, 47023 Cesena, Italy.
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Luigiano C, Ferrara F, Fabbri C, Ghersi S, Bassi M, Polifemo AM, Billi P, Fornelli A, Cinquantini F, D'Imperio N. Primary lymphoma of the common bile duct presenting with acute pancreatitis and cholangitis. Endoscopy 2010; 42 Suppl 2:E265-6. [PMID: 20931475 DOI: 10.1055/s-0030-1255766] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- C Luigiano
- Unit of Gastroenterology and Digestive Endoscopy, AUSL Bologna Bellaria-Maggiore Hospital, Bologna, Italy.
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Cennamo V, Fuccio L, Zagari RM, Eusebi LH, Ceroni L, Laterza L, Fabbri C, Bazzoli F. Can early precut implementation reduce endoscopic retrograde cholangiopancreatography-related complication risk? Meta-analysis of randomized controlled trials. Endoscopy 2010; 42:381-8. [PMID: 20306386 DOI: 10.1055/s-0029-1243992] [Citation(s) in RCA: 142] [Impact Index Per Article: 10.1] [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: 12/12/2022]
Abstract
BACKGROUND AND STUDY AIMS Precut papillotomy is considered a risk factor for endoscopic retrograde cholangiopancreatography (ERCP)-related complications; however whether the complication risk is due to precut itself or to the prior prolonged attempts is still debated; therefore, early precut implementation has been suggested to reduce the complication rate. We conducted a meta-analysis of randomized controlled trials (RCTs) comparing cannulation and complication rates of early precut implementation with persistent attempts by the standard approach. METHODS RCTs that compared cannulation and complication rates of the early precut implementation and of persistent attempts by the standard approach were included. Summary effect sizes were estimated by odds ratio (OR) with a random-effects model and by Peto OR. RESULTS Six RCTs with a total of 966 subjects met the inclusion criteria. Overall cannulation rates were 90 % in both randomization groups (OR 1.20; 95 % confidence interval [CI] 0.54 - 2.69). Post-ERCP pancreatitis developed in 2.5 % of patients randomized to the early precut groups and in 5.3 % of patients from the persistent attempts groups (OR 0.47; 95 %CI 0.24 - 0.91). The overall complication rates, considering pancreatitis, bleeding, cholangitis, and perforation rates, were 5.0 % in the early precut groups and 6.3 % in the persistent attempts groups (OR 0.78; 95 %CI 0.44 - 1.37). CONCLUSIONS RCTs that investigated the issue of timing of the precut procedure were limited. Current evidence suggests that in experienced hands the early implementation of precut and persistent cannulation attempts have similar overall cannulation rates; early precut implementation reduces post-ERCP pancreatitis risk but not the overall complication rate. Further studies are needed to confirm these findings.
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Affiliation(s)
- V Cennamo
- Department of Internal Medicine and Gastroenterology, University of Bologna, Italy
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Luigiano C, Ferrara F, Polifemo AM, Fabbri C, Ghersi S, Bassi M, D'Imperio N. Endoscopic closure of esophageal fistula using a novel "clips and loop" method. Endoscopy 2009; 41 Suppl 2:E249-50. [PMID: 19787575 DOI: 10.1055/s-0029-1214430] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- C Luigiano
- Unit of Gastroenterology and Digestive Endoscopy, AUSL Bologna, Bellaria-Maggiore Hospital, Bologna, Italy.
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Abstract
Background: the characteristics of 90Y, suitable for therapy, are denoted by the lack of γ-emission. Alternative methods, using analogues labelled with 111In or 86Y, are generally applied to image 90Y-conjugates, with some inevitable drawbacks. New generation SPECT/CT image systems offer improved Bremsstrahlung images. The intent of this brief communication is to show that high quality 90Y-Bremsstrahlung SPECT-CT images can be obtained, allowing the biodistribution of pure β-emitter therapeutical agents to be evaluated, also during the course of therapy. Methods: the hybrid system Siemens Symbia-T2 was used for the acquisition of images of a patient given 1.7 GBq of 90Y-DOTATATE. The following parameters were set for SPECT: 80 (50%) and 120 (30%) keV energy windows; medium energy collimators; 128 × 128 matrix, 64 projections (40s/step). Low-dose CT was acquired (80 mAs) for attenuation correction. Images were reconstructed with the OSEM 3D-Fast algorithm. Results: post-therapy SPECT-CT 90Y-Bremsstrahlung images of a patient undergoing receptor peptide radionuclide therapy are presented. 90Y-Bremsstrahlung images obtained are suitable for tumour and normal organ dosimetry, providing detailed information on biodistribution, comparable to 111In-diagnostic images. Conclusions: the improved Bremsstrahlung images means that the diagnostic examinations can be used for patient recruitment and that dosimetry evaluation can be restricted only to treated patients. This could avoid the need for a different radionuclide or isotope to mimic therapy. The clinical impact might be notable, as dosimetry and toxicity information are essential in radionuclide therapy, especially in patients with risk factors.
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Affiliation(s)
- C Fabbri
- Division of Medical Physics, Ospedale Bufalini, Cesena, Italy
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Franceschini G, Magno S, Fabbri C, Chiesa F, Di Leone A, Moschella F, Scafetta I, Scaldaferri A, Fragomeni S, Adesi Barone L, Terribile D, Salgarello M, Masetti R. Conservative and radical oncoplastic approches in the surgical treatment of breast cancer. Eur Rev Med Pharmacol Sci 2008; 12:387-396. [PMID: 19146201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
In the attempt to optimise the balance between the risk of local recurrence and the cosmetic outcomes in breast surgery, new surgical procedures, so-called oncoplastic techniques, have been introduced in recent years. The term oncoplastic surgery refers to surgery on the basis of oncological principles during which the techniques of plastic surgery are used, mostly for reconstructive and cosmetic reasons. The advantage of the oncoplastic surgery for breast cancer is the possibility of performing a wider excision of the tumour with a good cosmetic result. Oncoplastic surgery is a broad concept that can be used for several different combinations of oncological surgery and plastic surgery: excision of the tumour by reduction mammoplasty, tumour excision followed by remodelling mammoplasty, mastectomy with immediate reconstruction of the breast and partial mastectomy with reconstruction. Careful patient selection and preoperative planning are key components for the success of any oncoplastic operation for breast cancer. Accurate preoperative evaluation of the clinical and biological features of the tumour as well as of the morphological aspects of the breast allow the surgeon to make a decision if a conservative or radical approach is preferable and select the most effective oncoplastic surgical technique. In this review we summarise the indications, advantages and limitations of several oncoplastic procedures.
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Affiliation(s)
- G Franceschini
- Breast Unit, Department of Surgery, Catholic University of the Sacred Heart, Rome, Italy.
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Meluzzi A, Fabbri C, Folegatti E, Sirri F. Effect of less intensive rearing conditions on litter characteristics, growth performance, carcase injuries and meat quality of broilers. Br Poult Sci 2008; 49:509-15. [DOI: 10.1080/00071660802290424] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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