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Moro F, Giudice MT, Bolomini G, Moruzzi MC, Mascilini F, Quagliozzi L, Ciccarone F, Scambia G, Fagotti A, Valentin L, Testa AC. Imaging in gynecological disease (27): clinical and ultrasound characteristics of recurrent ovarian stromal cell tumors. Ultrasound Obstet Gynecol 2024; 63:399-407. [PMID: 37774092 DOI: 10.1002/uog.27504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 09/18/2023] [Accepted: 09/20/2023] [Indexed: 10/01/2023]
Abstract
OBJECTIVE To describe the clinical and ultrasound characteristics of recurrent granulosa cell and Sertoli-Leydig cell tumors. METHODS This was a retrospective observational study performed at Fondazione Policlinico Universitario A. Gemelli, Istituto di Ricovero e Cura a Carattere Scientifico, IRCCS, Rome (Gemelli center), Italy. Patients with a histological diagnosis of recurrent granulosa cell tumor or Sertoli-Leydig cell tumor were identified from the database of the Department of Gynecological Oncology. Those who had undergone a preoperative ultrasound examination at the Gemelli center between 2012 and 2020 were included, and the data retrieved from the original ultrasound reports. In all of these reports, the recurrent tumors were described using International Ovarian Tumor Analysis (IOTA) terminology. If a patient had more than one episode of relapse, information from all episodes was collected. If there was more than one recurrent tumor at the same ultrasound examination, all tumors were included. One expert sonographer also reviewed all available ultrasound images to identify typical ultrasound patterns using pattern recognition. RESULTS We identified 30 patients with a histological diagnosis of recurrent granulosa cell tumor (25 patients, 55 tumors) or Sertoli-Leydig cell tumor (five patients, seven tumors). All 30 had undergone at least one preoperative ultrasound examination at the Gemelli center and were included. These women had a total of 66 episodes of relapse, of which a preoperative ultrasound examination had been performed at the Gemelli center in 34, revealing 62 recurrent lesions: one in 22/34 (64.7%) episodes of relapse, two in 4/34 (11.8%) episodes and three or more in 8/34 (23.5%) episodes. Most recurrent granulosa cell tumors (38/55, 69.1%) and recurrent Sertoli-Leydig tumors (6/7, 85.7%) were classified as solid or multilocular-solid tumors, while 8/55 (14.5%) recurrent granulosa cell tumors and 1/7 (14.3%) recurrent Sertoli-Leydig cell tumors were unilocular cysts and 9/55 (16.4%) recurrent granulosa cell tumors were multilocular cysts. The nine unilocular cysts had contents that were anechoic (n = 2) or had low-level echogenicity (n = 7), had either smooth (n = 4) or irregular (n = 5) internal cyst walls, and ranged in largest diameter from 8 to 38 mm, with three being < 20 mm and five being 20-30 mm. On retrospective review of the images, two typical ultrasound patterns were described: small solid tumor measuring < 2 cm (15/62, 24.2%) and tumor with vascularized echogenic ground-glass-like content (12/62, 19.4%). CONCLUSIONS Some granulosa cell and Sertoli-Leydig cell recurrences manifest one of two typical ultrasound patterns, while some appear as unilocular cysts. These are usually classified as benign, but in patients being followed up for a granulosa cell tumor or Sertoli-Leydig cell tumor, a unilocular cyst should be considered suspicious of recurrence. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- F Moro
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
| | - M T Giudice
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
| | - G Bolomini
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
| | - M C Moruzzi
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
| | - F Mascilini
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
| | - L Quagliozzi
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
| | - F Ciccarone
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
| | - G Scambia
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
- Dipartimento Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - A Fagotti
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
- Dipartimento Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - L Valentin
- Skåne University Hospital Malmö, Malmö, Sweden
- Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - A C Testa
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
- Dipartimento Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
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Moro F, Mariotti F, Pira A, Sobrino L, Pallotta S, Panebianco A, Di Zenzo G. The impact of COVID-19 pandemic on the number of first diagnosis and follow-up visits of patients affected by pemphigus, bullous pemphigoid, scleroderma, psoriasis and vitiligo: A single-centre experience. J Eur Acad Dermatol Venereol 2024. [PMID: 38400642 DOI: 10.1111/jdv.19885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 02/05/2024] [Indexed: 02/25/2024]
Affiliation(s)
- Francesco Moro
- Molecular and Cell Biology Laboratory, Istituto Dermopatico dell'Immacolata (IDI)-IRCCS, Rome, Italy
- Dermatology Clinic, Istituto Dermopatico dell'Immacolata (IDI)-IRCCS, Rome, Italy
| | - Feliciana Mariotti
- Molecular and Cell Biology Laboratory, Istituto Dermopatico dell'Immacolata (IDI)-IRCCS, Rome, Italy
| | - Anna Pira
- Molecular and Cell Biology Laboratory, Istituto Dermopatico dell'Immacolata (IDI)-IRCCS, Rome, Italy
| | - Luciano Sobrino
- Informatic Systems, Istituto Dermopatico dell'Immacolata (IDI)-IRCCS, Rome, Italy
| | - Sabatino Pallotta
- Dermatology Clinic, Istituto Dermopatico dell'Immacolata (IDI)-IRCCS, Rome, Italy
| | - Annarita Panebianco
- Medical Direction, Istituto Dermopatico dell'Immacolata (IDI)-IRCCS, Rome, Italy
| | - Giovanni Di Zenzo
- Molecular and Cell Biology Laboratory, Istituto Dermopatico dell'Immacolata (IDI)-IRCCS, Rome, Italy
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Fusai GK, Raptis DA, Hilal MA, Bassi C, Besselink M, Conlon K, Davidson B, Del Chiaro M, Dervenis C, Frigerio I, Falconi M, Hackert T, Harrison EM, Shrikhande SV, Siriwardena A, Smith M, Wolfgang C, Borakati A, Balci D, Elhadi M, Salinas CH, Machairas N, Marchegiani G, Oba A, Oberkofler C, Passas I, Ravikumar R, Velázquez PS, de Santibañes M, Schnitzbauer AA, Soggiu F, Tamburrino D, Tinguely P, Wei A, Zachiotis M, Bentabak K, Kacimi SE, Nikfarjam M, Shcherba A, Sergeant G, Coelho G, Torres O, Belev N, Tang E, Diaz C, Wei K, Hendi M, Gouvas N, Christophides T, Nikov A, Fathallah D, Saad M, Tammik O, Huhta H, Sulpice L, Lupinacci R, Demetrashvili Z, Stavrou GA, Felekouras GE, Papaziogas V, Misra S, Talib H, Al-Sader MAJ, Satoi S, Obeidat K, Fakhradiyev I, Khalife M, Elhadi M, Dulskas A, Ghani S, Padilla AE, Melchor-Ruan J, Erdene S, Benkabbou A, Nashidengo P, Koea J, Adeyeye NA, Amro S, Alnammourah WM, The C, Pędziwiatr M, Polkowski W, Barbu ST, Galun D, Goh BKP, Trotovšek B, Omoshoro-Jones J, Ielpo B, Abdelmageed A, Sandström P, Cristaudi A, Gloor B, Kuemmerli C, Tishreen AH, Chaaban MK, Wu CH, Jen PCYF, Baraket O, Taylor M, Jamieson N, Iype S, Giorgakis E, Qadan M, Ganai S, Al-Naggar H, Chihaka O, El Behi A, Kouicem AT, Chibane A, Bouzid C, Bentabak K, Bouali I, Samai N, Aya B, Drid B, Tidjane A, Tabeti B, Boudjenan-Serradj N, Larbi MH, Ouahab I, Touabti S, Ilhem O, Bouaoud S, Meriem A, Ouyahia A, Kouicem AT, Abdoun M, Mounira R, Rais M, Riffi O, Kacimi SE, McCormack L, Capitanich P, Goransky J, de Santibanes M, Mazza O, Salazar IP, Ramallo DR, Pablo F, Gondolesi GE, Schelotto PB, Rodriguez J, Apostolou C, Merrett N, Fox A, Hassen S, Joglekar S, Gananadha S, Wake R, Hagen K, Sritharan M, Hall K, Muralidharan V, Brown K, Nikfarjam M, Croagh D, Sritharan M, Berry R, Fayed A, Hodgson R, Kuany T, Loveday B, Banting S, Rowcroft A, Fox A, Knowles B, Taylor L, Chong L, Banting S, Perini M, Nikfarjam M, Lin YJ, Alsoudani A, Burnett D, Shah K, Fuge M, Bull N, Chen S, Navadgi S, Ng ZQ, Johansson M, Azaman NSBB, Pearson A, Apostolou C, Mischinger H, Schemmer P, Kornprat P, Hauer A, Hauer A, Kirbes K, Klug R, Schrittwieser R, Klaus A, Entschev A, Reichhold D, Ugrekhelidze K, Fink M, Stoyanova R, Sabateen M, Mahfoodh Z, Shenawi HA, Yaghan R, Chowdhury M, Shcherba A, Kirkovsky L, Korotkov S, Van den Bossche B, Boterbergh K, Poortmans M, Smet B, Strypstein S, Feryn T, Wahib EM, oubella S, Roeyen G, Hartman V, Bracke B, Hendrikx B, Gryspeerdt F, Berrevoet F, Poortmans N, Apers T, Appeltans B, Appeltans B, Wicherts D, Sergeant G, Garcia FOB, dos Santos IB, Garcia R, Pinto R, Leite TLS, Anghinoni M, Nobre CCG, Coelho G, Machado IFS, Carvalho N, Morais L, Barros AV, Gomes G, Buarque IL, Osvaldt AB, Militz M, Boff M, Marcelino L, Guerra E, Torelly L, Waechter FL, Rodrigues P, Teixeira UF, Osvaldt A, Marcelino L, Militz M, De Mello E, Goncalves R, Balzan S, Ramos EJB, Moraes-Junior JMA, Torres OJM, da Silva DV, Coimbra F, Coimbra FJF, Marques N, Marques N, Torres SM, Sampaio A, Canteras CA, Ferreira F, Machado MA, Kleinubing D, Lellis L, Brum SL, Gohar M, Atanasov B, Slavchev MT, Slavchev M, Belev N, Krastev P, Takorov I, Vladov N, Kostadinov R, Lukanova T, Mihaylov V, Chernopolsky PM, Madjov R, Bozhkov VM, Kostov VD, Kostov D, Nikolaev E, Muhezagiro F, Niyonkuru J, Irakoze P, Dixon E, Lo E, Ruo L, D'Souza D, Serrano PE, Skaro A, Tang E, Glinka J, Martin J, Zogopoulos G, Metrakos P, Chaudhury P, Torres-Quevedo R, Brañes A, Brañes A, Diaz C, Buckel E, Butte J, Devaud N, Paqui L, Wei K, Wang H, Cai L, Guo S, Chen Y, Hendi M, Cheung TT, Millan C, Argüello P, Pavlek G, Silovski H, Petrovic I, Romic I, Zedelj J, Amic F, Kolovrat M, Rakic M, Mikulic D, Štironja I, Bubalo T, Gouvas N, Papatheodorou P, Christophides T, Burda L, Straka M, Klos D, Tesarikova J, Loveček M, Gregorik M, Skalicky P, Stögerová C, Fichtl J, TomአS, Zaruba P, Nikov A, Tschuor C, Mohamed M, Sayed B, Shaheen A, Farid A, Attalla A, Ibrahim DF, Fathallah D, Elmzaien E, Magdy B, Salah S, Saleh A, Saker AAE, Swealem A, Sallam EI, Rozza H, Bassiony M, Elhassan M, Elmalah M, Belal M, El Gohary M, Hassanin MA, Elsayed N, Aboelfath S, El-Sayes I, Tayiawi M, Altatari A, Altatari AM, Saleh A, Qatora MS, Said M, Najjar A, Alahmed F, Zamri FMB, Ealreibi H, Alahmed H, Alyasin I, Abdelhalim K, Alfatah MA, Sharaan MA, El Moneam MA, Abdelalemm M, Mourad M, Sohaimee NB, Abosamak NE, Suhaimi NMFB, Shokralla S, Dean YE, Tanas Y, Waffa Z, Nafea A, Ramadan D, Abdelaal A, Mahmoud A, Nafea AM, Abuali ASAME, Korayem I, Fahmy M, Ibraheem M, Hamouda M, Helaly R, Khdour YF, Khdour Y, Farag M, Ibrahim A, Elareibi HE, Alboridy M, Mansour A, Ragab MG, Naguib M, Allam S, Elfarag HA, Elsakka A, Mannaa D, Elkeleny M, Suhaimi NAB, Uzir SSBM, Nasr S, El-Najjar A, Dohien M, Dohien M, Osman N, Gad N, Hassanin M, Fadel BA, Hamdan EHM, Monib F, Saad M, Abbas A, Abu-Elfatth AM, Elazeem HAA, Abdelhafez MHZ, Omar N, Hassan R, Mohamed A, Mahmoud SH, Abobakr AM, Mohamed EEE, Ahmed R, Hamza HM, Mohammed M, Marshod MA, Hussein AMM, Taha A, Ibrahim I, Nageh MA, Fouly MN, Hassan RA, Mohamed AKA, Elnabi MH, Salah M, Ali AYM, Sayed EGA, Sayad R, Saad MM, Abdelkarem M, Omar NG, Khalifa A, Faragalla H, Barakat A, Barakat ATM, Elshafey A, Eleisawy MF, Eleisawy M, Zahed MSM, Zahed M, Omer M, Allam M, Abuelnaga Y, Abdelzaher A, Alnimr A, Dabbous H, Sayed H, Elgarhy I, Elmeteini M, Bahaa M, Farag M, Eid M, Anas O, Ismail O, Nageeb O, Lasheen R, Tanyous S, Diab S, Badran Y, Fahim A, Alazab E, Elgarhy IM, Abdeljalil M, Hanna M, Gobran M, Gobran M, Abdelmawla MOMK, Nagy M, Nageeb OE, Ramadan S, Abdelmawgoud S, Zidan T, Abuelnaga Y, Tarkhan Y, Saad A, Awad AK, Elbadawy MA, Abdelmawla M, Mansy E, Moharam M, Elabd M, Eldabour A, Elwakil L, Hassanien MS, Elnashar A, Saleh HED, Michail M, Said A, El Garhy M, Ahmed MBE, Anas O, Ismail O, Abboud K, Nabil A, Elfiky M, Murad A, Azzam A, Azab MA, Awad S, Othman Z, Fahim AM, Abdelzaher AT, Zidan T, Abdelrhman R, Tolis EAN, Salem M, Ebrahim H, Abdelrazek HA, Abdelmoneim N, Salman D, Saa'd H, Ali D, Farouk A, Mandor AR, Monier A, Shehta A, Kassem A, Sanad A, Elsaadany R, Shaat MM, Elmorsi R, Awad S, Ghedan S, Menessy A, Elnabawy D, Abdou K, Abdelmaksoud M, Hassan M, Elweza O, Elboraei R, Abdallah A, Metwally IH, Elhamamsy M, Fareed AM, Zuhdy M, Elbalka SS, Alansary MN, Omar M, Elgharably AA, Hager E, El Gady A, Alsharif DS, Shaaban AM, Alsharif D, Samaan D, Samaan SSS, Oteem A, Shaaban AM, Alsharif DS, Samaan S, Zayed A, Allam A, El Gady A, Alsharif DS, Badr K, Elnoamany S, Samaan SS, Ellibady M, Ahmed EA, Elbassyiouny A, Boalot A, Badr H, Gamal M, Abuelazm M, Othman Z, Eldaly A, Eldaly AS, Essa M, Abdelrahman F, Sarhan A, Alsabbagh F, Allah MA, Bayomi A, Salama M, kivisild M, Tammik O, Podramagi T, Huhta H, Kauppila JH, Nortunen M, Jouffret L, Sommacale D, Brustia R, Cherif R, Lecolle K, El Amrani M, Beugniez C, Truant S, Piessen G, Degisors S, Dupré A, Perinel J, Adham M, Sgarbura O, Souche FR, Iannelli A, Gugenheim J, Savvala N, Scatton O, Lupinacci R, Ragot E, Manceau G, Karoui M, Goasguen N, Anyla M, Gaujoux S, Rhaiem R, Piardi T, Robin F, Sulpice L, Roussel E, Papet E, Schwarz L, Felli E, Giannone F, Pessaux P, Pipia I, Khutsishvili K, Demetrashvili Z, Krones C, Wüllenweber HP, Bartella I, Kamphues C, Loch F, Pozios I, Belyaev O, Mohan PV, Uhl W, Bulian D, Juengling N, Thomaidis P, Korn S, Welsch T, Bork U, Praetorius C, Weitz J, Distler M, Krautz C, Brunner M, Grützmann R, Mazzella E, Hecker A, Reichert M, Azizian A, Gaedcke J, Ghadimi M, Aghdassi A, Döbereiner J, Klose J, Kleeff J, Ronellenfitsch U, Oldhafer KJ, Wagner K, Reese T, Heumann A, Uzunoglu FG, Izbicki J, Goetz M, Scognamiglio P, Honselmann K, Keck T, Wellner U, Struecker B, Hackl C, Brennfleck FW, Brunner S, Kardassis D, Schütze F, Stavrou GA, Ghamarnejad O, Metzger R, Koenigsrainer A, Nadalin S, Anthoni C, Makridis G, Farkas SA, Löb S, Nikou E, Tsoukalas N, Bairamidis E, Vaia A, Prountzopoulou A, Fradelos E, Kechagias A, Kelgiorgi D, Avgerinos K, Ioannidis A, Konstantinidis KM, Konstantinidis MK, Papakonstantinou D, Papiri I, Michalopoulos N, Petropoulou Z, Christodoulou S, Margaris I, Chatzialis I, Selmani J, Papadoliopoulou M, Arkadopoulos N, Kokoropoulos P, Vassiliu P, Parasyris S, Sidiropoulos T, Stamopoulos P, Stergiou D, Sotiropoulou M, Vaslamatzis M, Roukounakis N, Kapiris SA, Kapiris SA, Vougas V, Roukounakis N, Dimitroulis D, Mantas D, Kotsifa E, Kotsifa E, Tomara N, Tomara NK, Machairas N, Dorovinis P, Kykalos S, Tsirlis T, Larentzakis A, Vrakopoulou GZ, Tzimas G, Pagkratis S, Triantafyllidis I, Papalampros A, Polydorou A, Syllaios A, Kontopoulou C, Politis D, Vouros D, Schizas D, Kyros E, Felekouras E, Karavokyros I, Griniatsos J, Bramis K, Toutouzas K, Karydakis L, Konstadoulakis M, Memos N, Kanavidis P, Massaras D, Fragulidis G, Frountzas M, Kordeni K, Vezakis A, Iliakopoulos K, Chardalias L, Kyriazanos I, Kyriazanos I, Marougkas M, Stamos N, Giannakopoulos T, Kalles V, Balalis D, Manatakis D, Korkolis D, Bourazani M, Delis S, Cyrochristos D, Baltagiannis E, Glantzounis G, Stylianidis S, Diamantis A, Valaroutsos A, Magouliotis D, Zacharoulis D, Christodoulidis G, Tepetes K, Perivoliotis K, Fergadi M, Tsiotos G, Mulita F, Maroulis I, Vailas M, Zygomalas A, Karavias D, Kontis E, Katsaros I, Kopanakis N, Tooulias A, Christou C, Raptis D, Katsanos G, Beradze N, Papaziogas V, Papadopoulos VN, Giakoustidis D, Katsourakis A, Efthymiou E, Chatzis I, Ntinas A, Hatzitheoklitos E, Tsalis K, Koustas P, Apostolos K, Petras P, Tsaramanidis S, Iakovidis C, Zacharakis E, Marjai T, Bursics A, Dede K, Tölgyes T, Vereczkei A, Kelemen D, Robert P, Vasavada B, Vaishnav D, Pawar P, Suryawanshi P, Shinde RM, Piplani C, Singh A, Sahu SK, Choudhary SR, Gupta R, Ramamurthy A, Babu E, Karuparthi S, Kumar S, Purushothaman G, Sathyanesan J, Venkatesh NR, John S, Singh AK, Gupta R, Singh SK, Sharma D, Yadav K, Leekha N, Pippari R, Pandey M, Francis NJ, Kumar T, Jain S, Poonia DR, Vishnoi JR, Sharma N, Pareek P, Byshetty R, Misra S, Varshney V, Ray R, Gulati S, Ghatak S, Das K, Khamrui S, Ray S, Sebastian GM, Chand JT, Appukuttan M, Chaturvedi A, Akhtar N, Prakash P, Gupta S, Rajan S, Kumar V, Sonkar AA, Ozair A, Suresh V, Virk S, Narasimhan M, Ardhanari R, Ramachandran S, Jain D, Velagala JR, Chattopadhyay S, Vodyala C, Velagala JR, Motwani K, Prajapati R, Tilak S, Bansal V, Kalayarasan R, Bhalerao S, S IP, Chisthi MM, A N, Latheef A, Yadev I, Sreekumar RC, Yadev I, KV V, Pandey D, Tripathi M, Fuadi AF, Prabowo E, Abbood AH, Hammoodi H, Al-juaifari MA, Al-Isawi A, Al-Tekreeti S, Al-Ogaili M, Hashim HT, Sadot E, Apel R, Sulimani O, Solomonov E, Itzhaki O, Lavy R, Shapira Z, Nicolini D, Vivarelli M, Rossi MDR, Mocchegiani F, Memeo R, Vincenti L, Fedele S, Andriola V, Gurrado A, Meo GD, Testini M, Neri V, Zironda A, Trizzino A, Pinelli D, Colledan M, Pizzini P, Cirelli R, Masetti M, Zanello M, Jovine E, Mastrangelo L, Lombardi R, Casadei R, Malpaga A, Frena A, Patauner S, Ciola M, Andreuccetti J, Manzoni A, Hilal MA, de Graaf N, Alfano MS, Molfino S, Baiocchi GL, Pisanu A, Mellano A, Papa MV, Carlo ID, Donati M, Zanatta M, Basile PF, Antonucci A, Papis D, Pighin M, Celotti A, Sasia D, Allisiardi F, Borghi F, Maione F, Giraudo G, Migliore M, Salomone S, Giaccardi S, Testa V, Giacometti M, Zonta S, Taddei A, Risaliti M, Muiesan P, Urciuoli I, Bencini L, Moraldi L, Anastasi A, Canonico G, Nelli T, Storto GL, D'Acapito F, Ercolani G, Solaini L, Cucchetti A, Gardini A, Pacilio CA, Barberis A, Filauro M, De Cian F, Valente R, Didomenico S, Papadia FS, Di Domenico S, De Rosa R, Massobrio A, Scabini S, Carganico G, Pessia B, Sista F, Schietroma M, Spampinato MG, Garritano S, D'Ugo S, Marchese T, Saladino E, Cuticone G, Gullá N, Recordare A, Palumbo R, Giani A, Ferrari G, Mazzola M, Dondossola D, Rossi G, Caccamo L, Zerbi A, Nappo G, Montorsi M, Coppa J, Busset MDD, Mazzaferro V, Troci A, Frontali A, Crespi M, Baldi C, Benuzzi L, Ferrara F, Stella M, Capurso G, Falconi M, Tamburrino D, Benedetto FD, Magistri P, Ballarin R, Zanus G, Brizzolari M, Uggeri F, Gianotti L, Cereda M, Ferraro D, Iacomino A, Ferraro D, Pisaniello D, Vennarecci G, Pisaniello D, Rompianesi G, Troisi RI, Patrone R, Belli A, Izzo F, Palaia R, Gianpaolo M, Maida P, Pasquale T, Bassi D, Cillo U, Moletta L, Sperti C, Serafini S, Milanetto AC, Pasquali C, Tolin F, Gruppo M, De Simoni O, Buscemi S, Marino MV, Giuffrida M, Dallavalle R, Calabretto F, Cobianchi L, Pugliese L, Giardino A, Butturini G, Regi P, Kauffmann EF, Di Franco G, Morelli L, Furbetta N, Napoli N, Boggi U, Pinotti E, Montuori M, Giuliani A, Izzo ML, Zanini N, Veneroni L, Giordano M, Palini GM, Garulli G, Vaccara VL, de Rose AM, Giuliante F, Ardito F, Mingoli A, Sapienza P, Lapolla P, Petrucciani N, Cossa A, Coppola A, Belloni E, Nigri G, Tisone G, Angelico R, Manzia TM, Caputo D, Saverio SD, Porcu A, Perra T, Feo C, Deiana G, Sartarelli L, Pisconti S, Tonini V, Patrono D, Moro F, Grasso L, Brolese A, Ciarleglio F, Marcucci S, Nistri C, Massani M, Tommaso S, Galasso E, Zanus G, Brizzolari M, Romano M, Rossi S, Novello S, Ferrero A, Langella S, Armentano S, Russolillo N, Dario L, Intini S, Giovanni T, Recordare AG, Pirozzolo G, Palumbo R, Calabrese F, Querini G, Zonta S, Caneparo A, Giacometti M, De Francesco M, Balduzzi A, Guglielmi A, Ruzzenente A, Iacono C, Poletto E, Marchegiani G, Isa G, Malleo G, Alaimo L, Salvia R, Conci S, Crinò SF, Campagnaro T, Frigerio I, De Marchi F, Bonomo M, Napetti S, Frontali A, Chierici A, Cotsoglou C, Gjoni E, Paleino S, Granieri S, Hashimoto D, Satoi S, Yamamoto T, Uemura K, Matsumoto I, Kamei K, Maehira H, Tani M, Hirano S, Nakamura T, Asano T, Akahoshi K, Tanabe M, Ishii T, H Al Saffaf M, Hamoud MA, Khattab R, Alissawi S, Hassouneh A, Al-Maadani B, Alali MB, Hmdan QA, Obed A, Nijadat D, Al-Shami K, Al-shami M, Mohsen M, Al-Mallah R, Albaba S, Theab M, Massadeh N, Theab RAK, Wardeh S, Salahwardeh, Alissawi SZ, Mardini A, Arabiyat HAA, Arabiyat H, Al-Hyari A, Ababneh H, Naffa' MF, Buwaitel MM, Al-Mekhlafi A, Rababa H, Alzoubi M, Khamees A, Abuleil A, Almiani S, Obeidat K, Amarin Z, Al-Samawi A, Hammoud AAA, Hammad H, Alkhadem MA, Mahafdah MR, AlSaffaf M, Alsabah M, Hani MB, Hamoud MAAL, Alzghoul MW, Khattab RN, Shumrakh SK, Rababah A, Alghazo H, Rababah T, Khamees A, Awadi S, Sharie SA, Abdelnoor A, Shaout DM, Omarieh Q, Abu-Ghazal SY, Abu-Ghazal S, Shaout D, Abughazal SY, Fakhradiyev I, Tanabayeva S, Saliev T, Issabekov I, Spatayev Z, Han HS, Jo Y, Plaudis H, Martinsone KD, Atstupens K, Jawad M, Khalife M, Faraj WG, Alowjali F, Albaraesi MN, Aldressi W, Benamwor A, Ali SB, Saleh S, Alshatshat A, Younes E, Younes E, Ekhmaj R, Bahroun S, Bahroun SG, Ekhmaj R, Bahroun SG, Burgan D, Aalem HAA, El Hussain RK, Morgom M, Alshareea E, Ellafi AAD, Shoukrie S, Shamakhi TMO, Bareig E, Abusannuga M, Dkhakhni A, Gerwash AA, Gerwash A, Zawia A, Othman E, Binnawara M, Abdalsalam SJA, Aljamal S, Ahmeed S, Khalil WIA, Khalel W, Faraj T, Elhajdawe F, Emhemed M, Salem O, Abdulwahed E, Khalil W, Rhuma H, Alsori M, Mustafa T, Albarouni S, Albishti A, Elhadi M, Elkhuja T, Msherghi A, Hasan NSB, Hasan HB, Hasan NB, Gulbinas A, Barauskas G, Ignatavicius P, Riauka R, Vanagas T, Slepavicius A, Jurgaitis J, Dailidenas S, Eismontas V, Mikutaitis V, Šlepavičius A, Jurgaitis J, Mikutaitis V, Dulskas A, Kuliavas J, Aniukstyte L, Sileikis A, Gulla A, Šileikis A, Tumas J, Strupas K, Petrulionis M, Kvietkauskas M, Strupas K, Vito D, Rosso E, Tan JH, Zakaria AD, Mohamad IS, Meng LV, Huai TZ, Hayati F, Sellappan H, Maiyauen TK, Azman A, Chik I, Zuhdi Z, Yoong B, Soon KP, Kit KJ, Yoong BK, Koong JK, Koh PS, Ibrahim A, Abdullah NAN, Bong J, Ghani S, Zorrilla CF, Cruz MC, Valladares AM, Dominguez-Rosado I, Rosciano AEP, Sebastian GH, Melchor-Ruan J, Garcia-Herrera JS, Sandag E, Erdene S, Orgoi S, Korch M, Boutti AS, boumzebra Y, Boumzebra Y, Hourri F, Gouazar I, Belaid WA, Serji B, Tarik B, Tijani EH, Zentar A, Ghannam A, Bounaim A, Souadka A, Benkabbou A, El Ahmadi B, Amina H, Oumayma L, Amrani L, Majbar MA, Mohsine R, Elhassouni R, Echiguer S, Belkhadir Z, Nashidengo AP, Quayson F, Abebrese J, Nashidengo P, Adhikari KM, Lakhey PJ, Bhandari RS, Besselink MG, Bieze M, Augustinus S, Busch O, Pranger BK, Hoogwater FJH, Klaase JM, Meerdink M, Nijkamp MW, de Meijer VE, Koerkamp BG, van Eijck CHJ, Van Dam JL, Barbier L, Johnston P, Babor R, Chu MJJ, Oliver T, Wen D, Koea J, Koea J, Brown L, Srinivasa S, Bartlett A, Windsor J, Carr-Boyd P, Bindra V, Cross A, Connor S, Hore T, Gunawardene A, Welsh F, Mahadik M, Gordon A, Rossaak J, Adeyeye A, Enoch E, Kayode-Nissi V, Abiyere H, Alatise O, Okomayin A, Odion C, Tagar E, Sheshe AA, Muhammad AB, Garzali IU, Ajayi P, Kadri E, Jabri SA, Azri YA, Pal KMI, Siddiqui T, Waqar U, Waqar U, Chaudhry AA, Abbasy J, Khan MO, Shafqatullah S, Khokhar MI, Akbar A, Afzal A, Asghar M, Ullah S, Butt UI, Butt U, Bari H, Mohammad BN, Hameda M, Jayyab MA, Alzabadiah AHM, Adam I, Abuzaina K, Farid M, Emar MFM, Emar M, Zreqat Q, Titi R, Idkiedek SA, Amro S, Al-Qasrawi S, Almasri TA, Alnammourah WM, Kiswani G, Sinnokrot R, Harb ZA, Nafa'A H, Shtewi L, Salah AO, Joma ABA, Faraj S, Zitawi A, Dawood AJ, Saadeh I, Hmeedan A, Daraghmeh MAM, Janajreh ANA, Manassra F, Yassin LMA, Yassin R, Saleh AO, Faraj SM, Sulaiman AS, Khayyat Z, Joma ABA, Shawahni E, Salah A, khader A, Hammoudeh A, Abdulhaq A, Alawna R, Roman G, Targarona J, Grau RG, Molina R, Alegria CR, Coayla G, Enriquez JCM, Marcos JC, Hasiman AN, Teh C, Cerdeño R, David A, Sarmiento RI, Barroso RR, Alfonso C, Ang DD, Casupang A, Mamuric M, Jardinero JM, Motyka A, Flisińska M, Pierściński S, Mrowiec S, Rymarowicz J, Matyja M, Wikar T, Sierzega M, Pędziwiatr M, Richter P, Durczynski A, Kosztowny K, Ciesielski W, Wardeszkiewicz A, Szwedziak K, Wlazlak M, Grzasiak O, Szewczyk P, Hogendorf P, Wyroślak-Najs J, Rawicz-Pruszyński K, Sędłak K, Solecki M, Polkowski W, Słodkowski M, Wierzchowski M, Korcz W, Nazarewski L, Kornasiewicz O, Lopes M, Martins RM, Martins R, Vigia E, Silva DS, Davide J, Pereira A, Tenreiro N, Castro T, Eisa R, Diaconescu B, Ciubotaru C, Negoi I, Negoiţă V, Radulescu RB, Bacalbaşa N, Dima S, Dumitrascu T, Spanu A, Mardare M, Ginghina O, Catrina E, Brezean I, Misca M, Vilcu M, Aldoescu S, Petrea S, Bartos A, Liviu CC, Iancu I, Barbu ST, Bodea R, Mois E, Florin G, Hajjar NA, Matei S, Zaharie F, Scripcariu V, Musina AM, Roata CE, Dimofte GM, Velenciuc N, Lunca S, Ong WL, Ong WL, Duta C, Brebu D, Braicu V, Belyaev A, Popov A, Batova A, Katysheva A, Mizgirev D, Neledova L, Duberman B, Litvin A, Pobelenko A, Kuznetsov G, Khatkov I, Tyutyunnik P, Izrailov R, Bedzhanyan A, Petrenko K, Bredikhin M, Shatverian DG, Chardarov N, Bagmet N, Lyadov V, Mudryak D, Semenenko I, Tokarev M, Kriger A, Kaldarov A, Ivanov G, Kuchin D, Torgomyan G, Zagainov V, Davydkin V, Baranov AI, Drozdov E, Anatolievna LN, Abdullaev A, Gachabayov M, Ghunaim M, Alharthi M, Aljiffry M, Bogdanovic M, Zivanovic M, Bogdanovic A, Galun D, Dugalic V, Arbutina D, Milic L, Bezmarevic M, Antic A, Radenkovic D, Ignjatovic I, Zdujic P, Kmezic S, Karamarkovic A, Arbutina D, Juloski J, Radulovic R, Radulović R, Cuk V, Jeremic L, Radojkovic M, Stojanovic M, Golijanin D, Ignjatovic MK, Protic M, Chiow A, Seng LL, Thiruchelvam N, Poh BGK, Goh BKP, Quan DCW, Koh YX, TrotovŠek B, Petrič M, Djokić M, Tomazic A, Badovinac D, Loots E, Prodehl L, Khan MU, Marumo T, Devar JWS, Omoshoro-Jones J, Khan ZA, Jugmohan B, Valcarcel AQ, García BM, Mínguez J, Marcello M, Ramia J, Compañ A, Fernandes C, Morales M, Fernández JMV, Del Mar Rico-Morales M, Liñán MÁL, Figueras J, Soliva R, Butori E, Fondevila C, Ausania F, Martín B, Rodríguez M, Sánchez-Cabús S, Sánchez-Velázquez P, Arnau ABM, Domínguez RS, Ielpo B, Pinilla FB, Castro M, Valverde DP, Santos EPG, del Carmen Manzanares Campillo M, Ruiz P, Gutierrez EC, Falgueras L, Quer MTA, Shwely FA, Fragua RL, Gonzalez-Serna DB, Valmorisco MA, Beltran-Miranda P, Busquets J, Secanella L, Pelaez N, Plaza G, Duaigües MLG, álvarez PM, Escartín A, Loinaz C, Dziakova J, de la Serna S, Pérez-Aguirre E, Justo I, Saavedra J, Gomez JC, Boñar NL, Martín-Perez E, Di Martino M, de la Hoz Rogriguez Á, Marcacuzco A, Jiménez-Romero C, de la Rúa JFR, Hinojosa-Arco LC, Suárez-Muñoz MÁ, Martinez DF, Sanchez-Bueno F, Vazquez PG, de León AM, Saiz EC, García LS, Gonzalez-Pinto I, Rodríguez-Pino JC, Segura-Sampedro JJ, Morales R, Morales-Soriano R, Rotellar F, Zozaya G, Martí-Cruchaga P, López-Sánchez J, Muñoz-Bellvis L, Cuadrado A, ortega I, Fernández R, Gómez DD, Vera V, Padillo JP, Luque JB, Millan EI, Jorba R, García-Domingot MI, Redondo C, Cantos DM, Artigues E, Pozo CDD, Llorente CP, Martínez SN, Ibáñez CB, Ibáñez JM, Andujar RL, Dorcaratto D, Forner EM, Garces-Albir M, de Heredia JB, Montes-Manrique M, Rodriguez-Lopez M, Serrablo A, Milian D, Ruiz-Quijano P, Paterna-Lopez S, Dharmapala A, Dassanayake BK, Galketiya KB, Ibrahim AM, Hamid H, Alhaboob N, Abdelmageed A, Taha SSO, Vilhav C, Wennerblom JH, Bratlie SO, Bjornsson B, Lundgren L, Sandström P, Tingstedt B, Andersson R, Andersson B, Williamsson C, Sparrelid E, Holmberg M, Ghorbani P, Gkekas I, Kuemmerli C, Bolli M, Andreou A, Wenning AS, Gloor B, Peloso A, Toso C, Oldani G, Moeckli B, Wassmer CH, Cristaudi A, Pietro MH, Majno-Hurst PE, Roesel R, Abbassi F, Tarantino I, Steffen T, Ferrari C, Schmidt J, Meier O, Weber M, Gutknecht S, Jonas JP, Clavien PA, Al-Haj A, Aljaber A, Kayali AA, Kadoura L, Nashed E, Helaly H, Kayali H, Alhashemi M, Aloulou M, Alshaghel M, Mahli N, Al-Abed O, Azizeh O, Torab SS, Alkhaleel W, Aliwy MA, Alannaz O, Ghazal A, Masri R, Douba Z, Saad AS, Abdulmonem A, Shaban M, Alhouri AN, Alhouri A, Soliman A, Houri HNA, Houri HA, Omran S, Abbas A, Chaaban M, Kudmani MAA, Chaaban MK, Alhmaidi R, Yousef A, Youssef A, Nasri M, Alkhateb H, Almjersah A, Hassan N, Moussa A, Hamdan A, Hammed A, Alloush A, Hassan BH, Issa H, Dahhan HT, Souliman M, Hammed S, Tobba TM, Hamdan A, Ayoub S, Yu MC, Yang PC, Wu CH, Bouaziz H, Rahal K, Slim S, Karim A, Baraket O, Kchaou A, Houssem A, Said MA, Mabrouk MB, Hamida KB, Ghalleb M, Mahmoud AB, Maghrebi H, Kacem MJ, Tez M, Eminesariipek N, çetiindağ Ö, Tüzüner A, Karayalçin K, Emral AC, Dikmen K, Kerem M, Bayhan H, Türkoğlu MA, Iflazoğlu N, özet A, Aday U, öfkeli Ö, Gumusoglu A, Kabuli HA, Karabulut M, Peker K, Saglam S, Rahimi FSİ, Hanefa F, Isik A, Goksoy E, Dulundu E, Atici AE, Ozocak AB, Yegen C, Dural AC, Sahbaz NA, Ulgur HS, Aydin H, Ozkan OF, Duzgun O, çelik M, Pekmezci S, çoker A, Uguz A, Unalp OV, Sert I, Ertekin S, Ozbilgin M, Aydoğan S, Tekin E, Calik B, Yesilyurt D, Atici SD, Arıkan TB, Arıkan T, Gonullu E, Dikicier E, Capoglu R, Bayhan Z, Alfurais S, Colak E, Polat S, Çiftci AB, Milburn J, Jones C, Vass D, Taylor M, Dasari BVM, Kausar A, Sultana A, Subar D, Nunes Q, Skipworth J, Nwogwugwu O, van Laarhoven S, Kourdouli A, Awan AA, Bhatti I, Latif J, Hand F, Robertson F, Holroyd D, Holroyd D, Jamieson N, Lim W, Chang D, Frampton A, Lahiri R, Chakravartty S, Siddique H, Bashir M, Mcnally S, Young A, Smith A, Pine J, Garcea G, Haqq J, Malde D, Dunne D, Burridge I, Szatmary P, Hariharan D, Kocher H, Yip V, Khalil A, Nair AM, Liova I, O'Balogun A, Rothnie A, Chikkala B, Salinas CH, Frola C, Tsakiris C, Raptis D, Chasiotis D, Sharma D, Jessa F, Soggiu F, Fusai G, Kostakis I, Kathirvel M, Elnagar M, Dimitrokallis N, Iype S, Pericleous S, Mohamed A, Val ARD, Tinguely P, Likos-Corbett M, Afzal I, Bhogal R, Patel K, Siriwardena AK, de' Liguori Carino N, Sheen PA, Gareb F, Ammar K, Thakkar R, Pandanaboyana S, Leeds J, Gomez D, Gregory G, Ceresa C, Abbas H, Lazzereschi L, Reddy S, Gordon-Weeks A, Aroori S, Russell T, Roberts K, Chatzizacharias N, Sutcliffe R, Al-Sarireh B, Shingler G, Mortimer M, Skoryi D, Ilin I, Pisetska M, Cheverdiuk D, Kostyantyn K, Kopchak K, Kvasivka O, Valeriia S, Sumarokova V, Kryzhevskyi V, Sikachov S, Khomiak A, Malik A, Khomiak I, Bilyak A, Chooklin S, Chuklin S, Mikheiev I, Shylenko O, Klymenko A, Patel S, Cunningham S, Callery M, Kent T, Raut C, Wang J, Fairweather M, Sulciner M, Hirji S, Clancy T, Nebbia M, Qadan M, Musser A, Hogg M, Rodriquez J, Hamner J, Hennessy L, Dinerman A, Gupta A, Kimbrough C, Thompson R, Zeh HJ, Radi I, Polanco PM, Moris D, Lidsky ME, Lee D, Piper J, Gnerlich J, Tuvin D, Sticca R, Ganai S, Gusani N, Krinock D, Giorgakis E, Hardgrave H, Spencer-Cole RT, Klutts G, Hardgrave H, Nigh J, Nigh J, Andrade JCB, Mavros M, Osborn T, Ferrone C, O'Connor V, Boone B, Harris B, Schmidt C, Schrope B, Chabot J, Kluger M, Lasso ET, Nevler A, Yeo C, Ponzini F, Lavu H, Lamm R, Bowne W, Kyser N, Galanopoulos C, Abbasi A, Park J, Sham J, Dickerson L, Pillarisetty V, Sucandy I, Ross S, Winslow E, Hawksworth J, Radkani P, Fishbein T, Munoz AS, Lindberg J, Martins PN, Al-saban RAM, Al-Saban R, Al-Kubati W, Ghallab AAA, Alsanany GM, Almarashi H, Al-Samawi H, Al-Asadi MAMM, Alsayadi R, Hail S, Shream S, Bajjah HM, Al-Ameri S, Bajjah H, Al-Ameri SAAS, Al-Dowsh NA, AlDowsh NA, Al-Khawlani Q, Murshed YAA, Al-Shehari M, Jahaf AAD, Al-sharabi EAE, Aldumaini H, Alattas Z, Almassaudi A, Bajjah HMAH, Albakry R, Al-Naggar H, Shream SAA, Affary AA, Al-Markiz E, Al-Eryani F, Farhat H, Qadasi QA, Alwafy K, Abdualqader MYM, Ali RAAY, Albar A, Bleem HA, Galeb KSA, Ghushaim M, Sabbar M, Esmail M, Ali RAY, Salem RHM, Salem R, Saif W, Al-Faiq S, Alsharabi E, Hameed ATA, Almekhlafi T, Omairan A, Almarkiz E, Abduljawad H, Mansaleh O, Al-Melhani W, Abdualqader M, Al-Abdi R, Alwan HM, Mbanje C, Chihaka O. Pancreatic surgery outcomes: multicentre prospective snapshot study in 67 countries. Br J Surg 2024; 111:znad330. [PMID: 38743040 DOI: 10.1093/bjs/znad330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 08/31/2023] [Accepted: 09/15/2023] [Indexed: 05/16/2024]
Abstract
BACKGROUND Pancreatic surgery remains associated with high morbidity rates. Although postoperative mortality appears to have improved with specialization, the outcomes reported in the literature reflect the activity of highly specialized centres. The aim of this study was to evaluate the outcomes following pancreatic surgery worldwide. METHODS This was an international, prospective, multicentre, cross-sectional snapshot study of consecutive patients undergoing pancreatic operations worldwide in a 3-month interval in 2021. The primary outcome was postoperative mortality within 90 days of surgery. Multivariable logistic regression was used to explore relationships with Human Development Index (HDI) and other parameters. RESULTS A total of 4223 patients from 67 countries were analysed. A complication of any severity was detected in 68.7 per cent of patients (2901 of 4223). Major complication rates (Clavien-Dindo grade at least IIIa) were 24, 18, and 27 per cent, and mortality rates were 10, 5, and 5 per cent in low-to-middle-, high-, and very high-HDI countries respectively. The 90-day postoperative mortality rate was 5.4 per cent (229 of 4223) overall, but was significantly higher in the low-to-middle-HDI group (adjusted OR 2.88, 95 per cent c.i. 1.80 to 4.48). The overall failure-to-rescue rate was 21 per cent; however, it was 41 per cent in low-to-middle- compared with 19 per cent in very high-HDI countries. CONCLUSION Excess mortality in low-to-middle-HDI countries could be attributable to failure to rescue of patients from severe complications. The authors call for a collaborative response from international and regional associations of pancreatic surgeons to address management related to death from postoperative complications to tackle the global disparities in the outcomes of pancreatic surgery (NCT04652271; ISRCTN95140761).
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Moro F, Sinagra JLM, Salemme A, Fania L, Mariotti F, Pira A, Didona B, Di Zenzo G. Pemphigus: trigger and predisposing factors. Front Med (Lausanne) 2023; 10:1326359. [PMID: 38213911 PMCID: PMC10783816 DOI: 10.3389/fmed.2023.1326359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 11/29/2023] [Indexed: 01/13/2024] Open
Abstract
Pemphigus is a life-threatening autoimmune blistering disease affecting skin and mucous membranes. Despite its etiopathogenesis remains largely unknown, several trigger and predisposing factors have been reported. Pemphigus is caused by autoantibodies that target desmoglein 1 and desmoglein 3, impacting desmosome function. However, circulating autoantibodies are often the consequence of a precipitating factor that occurs in predisposed individuals. This review aims to describe and discuss almost all trigger and predisposing factors reported as possible or probable cause of the disease. Among the reported trigger factors that may induce or exacerbate pemphigus, we have found of particular interest: drug intake (especially thiol- and phenol-containing compounds), vaccines, infections, as well as some reports about pregnancy, radiations, emotional stress, pesticides and physical trauma. Moreover, we discuss the possible role of food intake in pemphigus onset and particular attention is given to dietary factors containing thiol, phenol and tannin compounds. A trigger factor is "the straw that breaks the camel's back," and often acts together with predisposing factors. Here we discuss how pemphigus onset may be influenced by genetic susceptibility and comorbidities like thyroid diseases, malignancies and other autoimmune disorders. To identify other hitherto unknown trigger and predisposing factors, well designed prospective studies are needed. In this context, future research should explore their connection with the aim to advance our understanding of pemphigus pathogenesis.
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Affiliation(s)
- Francesco Moro
- Molecular and Cell Biology Laboratory, Istituto Dermopatico dell’Immacolata (IDI)-IRCCS, Rome, Italy
- Dermatology Clinic, Istituto Dermopatico dell’Immacolata (IDI)-IRCCS, Rome, Italy
| | - Jo Linda Maria Sinagra
- Molecular and Cell Biology Laboratory, Istituto Dermopatico dell’Immacolata (IDI)-IRCCS, Rome, Italy
- Dermatology Clinic, Istituto Dermopatico dell’Immacolata (IDI)-IRCCS, Rome, Italy
| | - Adele Salemme
- Molecular and Cell Biology Laboratory, Istituto Dermopatico dell’Immacolata (IDI)-IRCCS, Rome, Italy
| | - Luca Fania
- Dermatology Clinic, Istituto Dermopatico dell’Immacolata (IDI)-IRCCS, Rome, Italy
| | - Feliciana Mariotti
- Molecular and Cell Biology Laboratory, Istituto Dermopatico dell’Immacolata (IDI)-IRCCS, Rome, Italy
| | - Anna Pira
- Molecular and Cell Biology Laboratory, Istituto Dermopatico dell’Immacolata (IDI)-IRCCS, Rome, Italy
| | - Biagio Didona
- Rare Diseases Unit, Istituto Dermopatico dell’Immacolata (IDI)-IRCCS, Rome, Italy
| | - Giovanni Di Zenzo
- Molecular and Cell Biology Laboratory, Istituto Dermopatico dell’Immacolata (IDI)-IRCCS, Rome, Italy
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Moro F, Zermano S, Ianieri MM, De Cicco Nardone A, Carfagna P, Ciccarone F, Ercoli A, Querleu D, Scambia G, Testa AC. Dynamic transvaginal ultrasound examination for assessing anatomy of parametrium. Ultrasound Obstet Gynecol 2023; 62:904-906. [PMID: 37470676 DOI: 10.1002/uog.26313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 07/03/2023] [Accepted: 07/06/2023] [Indexed: 07/21/2023]
Affiliation(s)
- F Moro
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
| | - S Zermano
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
| | - M M Ianieri
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
| | - A De Cicco Nardone
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
| | - P Carfagna
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
| | - F Ciccarone
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
| | - A Ercoli
- University of Messina, Department of Human Pathology of Adult and Childhood 'G. Barresi', Unit of Gynecology and Obstetrics, Messina, Italy
| | - D Querleu
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
| | - G Scambia
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
- Università Cattolica del Sacro Cuore, Istituto di Clinica Ostetrica e Ginecologica, Rome, Italy
| | - A C Testa
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
- Università Cattolica del Sacro Cuore, Istituto di Clinica Ostetrica e Ginecologica, Rome, Italy
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6
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Curcio C, Rosso T, Brugiapaglia S, Guadagnin G, Giordano D, Castellino B, Satolli MA, Spadi R, Campra D, Moro F, Papotti MG, Bertero L, Cassoni P, De Angelis C, Langella S, Ferrero A, Armentano S, Bellotti G, Fenocchio E, Nuzzo A, Ciccone G, Novelli F. Circulating autoantibodies to alpha-enolase (ENO1) and far upstream element-binding protein 1 (FUBP1) are negative prognostic factors for pancreatic cancer patient survival. Clin Exp Med 2023; 23:5089-5100. [PMID: 37910256 PMCID: PMC10725354 DOI: 10.1007/s10238-023-01236-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 10/24/2023] [Indexed: 11/03/2023]
Abstract
Pancreatic ductal adenocarcinoma (PDA) has a dismal prognosis due to a lack of early diagnostic markers and effective therapy. In PDA patients, the glycolytic enzyme and plasminogen receptor alpha-enolase (ENO1) and the transcription factor far upstream element-binding protein 1 (FUBP1) are upregulated and elicit the production of autoantibodies (aAb) that discriminate healthy subjects from PDA patients, with the latter mostly directed to post-translational phosphorylated isoforms. Here, the correlation of prognosis with circulating ENO1 and FUBP1aAb, and their protein tissue expression was analyzed in PDA patients. Circulating ENO1 and FUBP1 aAb was analyzed in two cohorts of PDA patients by ELISA (n = 470), while tissues expression was observed by immunohistochemistry (n = 45). Overall survival (OS) was estimated using the Kaplan-Meier method, while the Cox model was used to estimate the hazard ratios (HR) adjusted for the main prognostic factors. Logistic models were applied to assess associations between death and its risk indicators. All statistical analyses were performed with Stata version 15. Unlike ENO1 aAb, there was a significant correlation between FUBP1 aAb and FUBP1 expression in tumors (p = 0.0268). In addition, we found that high ENO1 (p = 0.016) and intermediate FUBP1 aAb levels (p = 0.013) were unfavorable prognostic factors. Notably, it was found that high anti-FUBP1 aAb level is a good prognostic marker for tail-body PDA (p = 0.016). Our results suggest that different levels of circulating aAb to ENO1 and FUBP1 predict a poor outcome in PDA patients and can be used to improve therapeutic strategies.
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Affiliation(s)
- Claudia Curcio
- Laboratory of Tumor Immunology, Department of Molecular Biotechnology and Health Sciences, University of Torino, Turin, Italy
- ENOAPA Biobank, SSD Banche Tessuti E Bioconservatorio, AOU Città Della Salute E Della Scienza Di Torino, Turin, Italy
| | - Tiziana Rosso
- Unit of Clinical Epidemiology, AOU Città Della Salute E Della Scienza Di Torino and CPO Piemonte, Turin, Italy
| | - Silvia Brugiapaglia
- Laboratory of Tumor Immunology, Department of Molecular Biotechnology and Health Sciences, University of Torino, Turin, Italy
- ENOAPA Biobank, SSD Banche Tessuti E Bioconservatorio, AOU Città Della Salute E Della Scienza Di Torino, Turin, Italy
| | - Giorgia Guadagnin
- Laboratory of Tumor Immunology, Department of Molecular Biotechnology and Health Sciences, University of Torino, Turin, Italy
- ENOAPA Biobank, SSD Banche Tessuti E Bioconservatorio, AOU Città Della Salute E Della Scienza Di Torino, Turin, Italy
| | - Daniele Giordano
- Laboratory of Tumor Immunology, Department of Molecular Biotechnology and Health Sciences, University of Torino, Turin, Italy
- ENOAPA Biobank, SSD Banche Tessuti E Bioconservatorio, AOU Città Della Salute E Della Scienza Di Torino, Turin, Italy
| | - Bruno Castellino
- Centro Oncologico Ematologico Subalpino, AOU Città Della Salute E Della Scienza Di Torino, Turin, Italy
| | - Maria Antonietta Satolli
- Centro Oncologico Ematologico Subalpino, AOU Città Della Salute E Della Scienza Di Torino, Turin, Italy
| | - Rosella Spadi
- Centro Oncologico Ematologico Subalpino, AOU Città Della Salute E Della Scienza Di Torino, Turin, Italy
| | - Donata Campra
- SC Chirurgia Generale d'urgenza E Pronto Soccorso, AOU Città Della Salute E Della Scienza Di Torino, Turin, Italy
| | - Francesco Moro
- SC Chirurgia Generale U2, AOU Città Della Salute E Della Scienza Di Torino, Turin, Italy
| | - Mauro Giulio Papotti
- Pathology Unit, Department of Medical Sciences, University of Torino, AOU Città Della Salute E Della Scienza Di Torino, Turin, Italy
| | - Luca Bertero
- Pathology Unit, Department of Medical Sciences, University of Torino, AOU Città Della Salute E Della Scienza Di Torino, Turin, Italy
| | - Paola Cassoni
- Pathology Unit, Department of Medical Sciences, University of Torino, AOU Città Della Salute E Della Scienza Di Torino, Turin, Italy
| | - Claudio De Angelis
- SCDU Gastroenterology U, AOU Città Della Salute E Della Scienza Di Torino, Turin, Italy
| | - Serena Langella
- General Surgery and Oncology, Ordine Mauriziano Di Torino, Turin, Italy
| | | | - Serena Armentano
- General Surgery and Oncology, Ordine Mauriziano Di Torino, Turin, Italy
| | - Giovanna Bellotti
- Oncology Department, SS. Antonio E Biagio C. Arrigo Di Alessandria, Alessandria, Italy
| | | | - Annamaria Nuzzo
- Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Turin, Italy
| | - Giovannino Ciccone
- Unit of Clinical Epidemiology, AOU Città Della Salute E Della Scienza Di Torino and CPO Piemonte, Turin, Italy
| | - Francesco Novelli
- Laboratory of Tumor Immunology, Department of Molecular Biotechnology and Health Sciences, University of Torino, Turin, Italy.
- ENOAPA Biobank, SSD Banche Tessuti E Bioconservatorio, AOU Città Della Salute E Della Scienza Di Torino, Turin, Italy.
- Department of Molecular Biotechnology and Health Sciences, Molecular Biotechnology Center, Piazza Nizza 44B, Turin, Italy.
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7
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Pozzati F, Sassu CM, Marini G, Mascilini F, Biscione A, Giannarelli D, Garganese G, Fragomeni SM, Scambia G, Testa AC, Moro F. Subjective assessment and IOTA ADNEX model in evaluation of adnexal masses in patients with history of breast cancer. Ultrasound Obstet Gynecol 2023; 62:594-602. [PMID: 37204769 DOI: 10.1002/uog.26253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 03/14/2023] [Accepted: 04/18/2023] [Indexed: 05/20/2023]
Abstract
OBJECTIVE To evaluate the performance of subjective assessment and the Assessment of Different NEoplasias in the adneXa (ADNEX) model in discriminating between benign and malignant adnexal tumors and between metastatic and primary adnexal tumors in patients with a personal history of breast cancer. METHODS This was a retrospective single-center study including patients with a history of breast cancer who underwent surgery for an adnexal mass between 2013 and 2020. All patients had been examined with transvaginal or transrectal ultrasound using a standardized examination technique and all ultrasound reports had been stored and were retrieved for the purposes of this study. The specific diagnosis suggested by the original ultrasound examiner in the retrieved report was analyzed. For each mass, the ADNEX model risks were calculated prospectively and the highest relative risk was used to categorize each into one of five categories (benign, borderline, primary Stage I, primary Stages II-IV or metastatic ovarian cancer) for analysis of the ADNEX model in predicting the specific tumor type. The performance of subjective assessment and the ADNEX model in discriminating between benign and malignant adnexal tumors and between primary and metastatic adnexal tumors was evaluated, using final histology as the reference standard. RESULTS Included in the study were 202 women with a history of breast cancer who underwent surgery for an adnexal mass. At histology, 93/202 (46.0%) masses were benign, 76/202 (37.6%) were primary malignancies (four borderline and 72 invasive tumors) and 33/202 (16.3%) were metastases. The original ultrasound examiner classified correctly 79/93 (84.9%) benign adnexal masses, 72/76 (94.7%) primary adnexal malignancies and 30/33 (90.9%) metastatic tumors. Subjective ultrasound evaluation had a sensitivity of 93.6%, specificity of 84.9% and accuracy of 89.6%, while the ADNEX model had higher sensitivity (98.2%) but lower specificity (78.5%), with similar accuracy (89.1%), in discriminating between benign and malignant ovarian masses. Subjective evaluation had a sensitivity of 51.5%, specificity of 88.8% and accuracy of 82.7% in distinguishing metastatic and primary tumors (including benign, borderline and invasive tumors), and the ADNEX model had a sensitivity of 63.6%, specificity of 84.6% and similar accuracy (81.2%). CONCLUSIONS The performance of subjective assessment and the ADNEX model in discriminating between benign and malignant adnexal masses in this series of patients with history of breast cancer was relatively similar. Both subjective assessment and the ADNEX model demonstrated good accuracy and specificity in discriminating between metastatic and primary tumors, but the sensitivity was low. © 2023 International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- F Pozzati
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - C M Sassu
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - G Marini
- Dipartimento Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - F Mascilini
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - A Biscione
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - D Giannarelli
- Facility of Epidemiology and Biostatistics, G-STEP Generator, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - G Garganese
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
- Dipartimento Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - S M Fragomeni
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - G Scambia
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
- Dipartimento Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - A C Testa
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
- Dipartimento Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - F Moro
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
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8
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Gesualdo M, Bertetti NS, Mortara U, Maletta F, Moro F, Sacco M, Bruno M, De Angelis CG, Gaia S. Pancreatic leiomyosarcoma: EUS findings of an uncommon pancreatic mass (with video). Endosc Ultrasound 2023; 12:435-436. [PMID: 37969164 PMCID: PMC10631615 DOI: 10.1097/eus.0000000000000037] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 06/27/2023] [Indexed: 11/17/2023] Open
Affiliation(s)
- Marcantonio Gesualdo
- AOU Città della Salute e della Scienza di Torino, University of Turin, Gastroenterology Department, Endoscopy Unit, Turin, Italy
| | - Noemi Sara Bertetti
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Umberto Mortara
- Pathology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Francesca Maletta
- Pathology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Francesco Moro
- General Surgery 2U and Liver Transplantation Center, University of Turin, Turin, Italy
| | - Marco Sacco
- AOU Città della Salute e della Scienza di Torino, University of Turin, Gastroenterology Department, Endoscopy Unit, Turin, Italy
| | - Mauro Bruno
- AOU Città della Salute e della Scienza di Torino, University of Turin, Gastroenterology Department, Endoscopy Unit, Turin, Italy
| | - Claudio Giovanni De Angelis
- AOU Città della Salute e della Scienza di Torino, University of Turin, Gastroenterology Department, Endoscopy Unit, Turin, Italy
| | - Silvia Gaia
- AOU Città della Salute e della Scienza di Torino, University of Turin, Gastroenterology Department, Endoscopy Unit, Turin, Italy
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9
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Flammini D, Chaudhary A, Colangeli A, Fonnesu N, Guirao J, Gupta K, Kalwale S, Mariano G, Moro F, Previti A, Quatrevaux M, Shigin P, Udintsev V, Villari R. Neutronic analyses for the equatorial diagnostic port plug #12 in ITER. Fusion Engineering and Design 2023. [DOI: 10.1016/j.fusengdes.2023.113639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
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10
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Merli M, Accorinti M, Romagnuolo M, Marzano A, Di Zenzo G, Moro F, Antiga E, Maglie R, Cozzani E, Parodi A, Gasparini G, Sollena P, De Simone C, Caproni M, Pisano L, Fattore D, Balestri R, Sena P, Vezzoli P, Teoli M, Ardigò M, Vassallo C, Michelerio A, Satta RR, Dika E, Melotti B, Ribero S, Quaglino P. Autoimmune bullous dermatoses in cancer patients treated by immunotherapy: a literature review and Italian multicentric experience. Front Med (Lausanne) 2023; 10:1208418. [PMID: 37547602 PMCID: PMC10400335 DOI: 10.3389/fmed.2023.1208418] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 06/30/2023] [Indexed: 08/08/2023] Open
Abstract
Cutaneous immune-related adverse events are frequently associated with immune checkpoint inhibitors (ICIs) administration in cancer patients. In fact, these monoclonal antibodies bind the cytotoxic T-lymphocyte antigen-4 and programmed cell death-1/ligand 1 leading to a non-specific activation of the immune system against both tumoral cells and self-antigens. The skin is the most frequently affected organ system appearing involved especially by inflammatory manifestations such as maculopapular, lichenoid, psoriatic, and eczematous eruptions. Although less common, ICI-induced autoimmune blistering diseases have also been reported, with an estimated overall incidence of less than 5%. Bullous pemphigoid-like eruption is the predominant phenotype, while lichen planus pemphigoides, pemphigus vulgaris, and mucous membrane pemphigoid have been described anecdotally. Overall, they have a wide range of clinical presentations and often overlap with each other leading to a delayed diagnosis. Achieving adequate control of skin toxicity in these cases often requires immunosuppressive systemic therapies and/or interruption of ICI treatment, presenting a therapeutic challenge in the context of cancer management. In this study, we present a case series from Italy based on a multicenter, retrospective, observational study, which included 45 patients treated with ICIs who developed ICI-induced bullous pemphigoid. In addition, we performed a comprehensive review to identify the cases reported in the literature on ICI-induced autoimmune bullous diseases. Several theories seeking their underlying pathogenesis have been reported and this work aims to better understand what is known so far on this issue.
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Affiliation(s)
- Martina Merli
- Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Martina Accorinti
- Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Maurizio Romagnuolo
- Dermatology Unit, Department of Internal Medicine, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Università Degli Studi di Milano, Milan, Italy
| | - Angelo Marzano
- Dermatology Unit, Department of Internal Medicine, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Università Degli Studi di Milano, Milan, Italy
| | - Giovanni Di Zenzo
- Laboratory of Molecular and Cell Biology, Istituto Dermopatico dell’Immacolata (IDI)-IRCCS, Rome, Italy
| | - Francesco Moro
- Laboratory of Molecular and Cell Biology, Istituto Dermopatico dell’Immacolata (IDI)-IRCCS, Rome, Italy
| | - Emiliano Antiga
- Section of Dermatology, Department of Health Sciences, University of Florence, Florence, Italy
| | - Roberto Maglie
- Section of Dermatology, Department of Health Sciences, University of Florence, Florence, Italy
| | - Emanuele Cozzani
- Section of Dermatology, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
- Dermatology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Aurora Parodi
- Section of Dermatology, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
- Dermatology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Giulia Gasparini
- Section of Dermatology, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
- Dermatology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Pietro Sollena
- Dermatology Unit, Department of Surgical and Medical Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Clara De Simone
- Dermatology Unit, Department of Surgical and Medical Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Dermatology Unit, University Department of Medicine and Translational Surgery, Università Cattolica Del Sacro Cuore, Rome, Italy
| | - Marzia Caproni
- Immunopathology and Rare Skin Diseases Unit, Section of Dermatology, Department of Health Sciences, Azienda Unità Sanitaria Locale Toscana Centro, University of Florence, Florence, Italy
| | - Luigi Pisano
- Section of Dermatology, Department of Health Sciences, Azienda Unità Sanitaria Locale Toscana Centro, University of Florence, Florence, Italy
| | - Davide Fattore
- Section of Dermatology, Department of Clinical Medicine and Surgery, Università Degli Studi di Napoli Federico II, Naples, Italy
| | - Riccardo Balestri
- Division of Dermatology, Outpatient Consultation for Rare Diseases, APSS, Trento, Italy
| | - Paolo Sena
- Dermatology Unit ASST-Papa Giovanni XXIII, Bergamo, Italy
| | - Pamela Vezzoli
- Dermatology Unit ASST-Papa Giovanni XXIII, Bergamo, Italy
| | - Miriam Teoli
- Porphyria and Rare Diseases, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Marco Ardigò
- Porphyria and Rare Diseases, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Camilla Vassallo
- Dermatology Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Andrea Michelerio
- Dermatology Unit, Ospedale Cardinal Massaia, Asti, Italy
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Rosanna Rita Satta
- Department of Medical, Surgical, and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Emi Dika
- Melanoma Center, Dermatology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Unit of Dermatology, Department of Medical and Surgical Sciences, DIMEC, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Barbara Melotti
- Oncology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Simone Ribero
- Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Pietro Quaglino
- Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
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11
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Librandi K, Grimaldi S, Catalano S, Moro F, Vallero SG, Spada M, Porta F. Insulinoma in pediatric tuberous sclerosis complex: a case report. Front Pediatr 2023; 11:1216201. [PMID: 37601129 PMCID: PMC10436085 DOI: 10.3389/fped.2023.1216201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 07/03/2023] [Indexed: 08/22/2023] Open
Abstract
Background Tuberous sclerosis complex (TSC) is a rare multisystemic disorder. This genetically determined disease is characterized by highly variable clinical expression, including epilepsy as a common feature. Seizures can also occur as a manifestation of symptomatic hypoglycemia. The latter could be caused by an insulinoma, whose association to TSC has already been debated. In TSC-associated tumors, dysregulation of the mTOR pathway is believed to be present, leading to significant impacts on cellular metabolism, growht, and proliferation. To date, the association between TSC and insulinoma has been reported in 11 adults. Here, we present the first case of a pediatric patient with TSC diagnosed with an insulinoma and review the existing literature on this topic. Case presentation A 11-year-old female with TSC presented with seizures unresponsive to standard therapy. Further investigation revealed that these seizures were caused by hypoglycemia. Subsequent evaluation led to the diagnosis of a pancreatic insulinoma, which was surgically removed. Following the procedure, the patient was free from seizures. Conclusions In individuals with TSC, the recurrence of epileptiform episodes throughout their lifetime, especially if previously well controlled with antiepileptic therapy, should raise suspicion for hypoglycemic events. These events may potentially be associated with the presence of an insulinoma. Further research and increased awareness are necessary to gain a better understanding of the association between TSC and insulinomas, and to guide clinical management strategies.
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Affiliation(s)
- Katia Librandi
- Postgraduate School of Pediatrics, University of Turin, Turin, Italy
| | - Serena Grimaldi
- Department of Nuclear Medicine, University of Turin, Turin, Italy
| | | | | | | | - Marco Spada
- Department of Pediatrics, University of Turin, Turin, Italy
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12
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Romiti A, Moro F, Ricci L, Codeca C, Pozzati F, Viggiano M, Vicario R, Fabietti I, Scambia G, Bagolan P, Testa AC, Caforio L. Using IOTA terminology to evaluate fetal ovarian cysts: analysis of 51 cysts over 10-year period. Ultrasound Obstet Gynecol 2023; 61:408-414. [PMID: 36123819 DOI: 10.1002/uog.26061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 08/09/2022] [Accepted: 08/18/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES To describe ultrasound features of fetal ovarian cysts as reported by the original ultrasound examiner, to apply International Ovarian Tumor Analysis (IOTA) terminology after retrospective analysis of the images and to describe patient management and evolution of fetal cysts during pregnancy and after delivery. METHODS This retrospective observational study included pregnant women diagnosed on ultrasound examination with a fetal ovarian cyst at the Prenatal Diagnosis Division of the Bambino Gesù Children's Hospital, in Rome, between March 2011 and May 2020. Cysts were classified by the original ultrasound examiner as 'simple' (unilocular anechoic cyst) or 'complex' (cyst with other morphology). In addition, three ultrasound examiners, experienced in gynecologic ultrasound, classified retrospectively the fetal ovarian cysts according to IOTA terminology, by reviewing stored ultrasound images. The evolution of these fetal ovarian cysts during pregnancy and after birth was recorded. RESULTS Included were 51 ovarian cysts in 48 fetuses. Of the 51 cysts, 29 (56.9%) had been classified by the original ultrasound examiner as 'simple', and 22 (43.1%) as 'complex'. Of the simple cysts, the majority (20/29 (69.0%)) resolved spontaneously after delivery, 2/29 (6.9%) resolved following intrauterine aspiration, 2/29 (6.9%) resolved after postnatal aspiration and 5/29 (17.2%) underwent surgery due to persistence after delivery; in all five, normal ovarian parenchyma without signs of necrosis was observed at histology. Of the complex cysts, 7/22 (31.8%) resolved spontaneously. The other 15/22 (68.2%) were removed surgically and, at histology, necrosis was observed in most (12/15 (80.0%)), while a benign epithelial cyst with normal ovarian parenchyma was observed in 3/15 (20%). After reviewing the ultrasound images and applying IOTA terminology, all 51 (100%) fetal cysts were described as unilocular; 29/51 (56.9%) cysts showed anechoic content (described as simple cysts by the original ultrasound examiner), and 10/51 (19.6%) had low-level, 1/51 (2.0%) had ground-glass, 9/51 (17.6%) had hemorrhagic, 1/51 (2.0%) had mixed and 1/51 (2.0%) had undefined content (all described as complex by the original ultrasound examiner). Among the 29 anechoic ovarian cysts, resolution was observed in most (24/29, 82.8%) cases. Similarly, resolution was observed in 7/10 (70.0%) cysts with low-level content. Resolution was not observed in any of the other 12 cysts and all of these cases underwent surgery, with evidence of necrosis being observed in 11 (91.7%). CONCLUSIONS Applying IOTA terminology provided a more detailed and accurate description of fetal ovarian cysts compared with the original classification into 'simple' and 'complex' categories. Anechoic cysts (described as simple cysts by the original ultrasound examiner) and cysts with low-level content (described as complex by the original ultrasound examiner) frequently resolved spontaneously. Cysts with ground-glass, hemorrhagic, mixed or undefined content were frequently associated with necrosis at histology following surgery. © 2022 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- A Romiti
- Bambino Gesù Children's Hospital, Medical and Surgical Department of Foetus-Newborn-Infant, IRCCS, Rome, Italy
| | - F Moro
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
| | - L Ricci
- Bambino Gesù Children's Hospital, Medical and Surgical Department of Foetus-Newborn-Infant, IRCCS, Rome, Italy
| | - C Codeca
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
| | - F Pozzati
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
| | - M Viggiano
- Bambino Gesù Children's Hospital, Medical and Surgical Department of Foetus-Newborn-Infant, IRCCS, Rome, Italy
| | - R Vicario
- Bambino Gesù Children's Hospital, Medical and Surgical Department of Foetus-Newborn-Infant, IRCCS, Rome, Italy
| | - I Fabietti
- Bambino Gesù Children's Hospital, Medical and Surgical Department of Foetus-Newborn-Infant, IRCCS, Rome, Italy
| | - G Scambia
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
- Università Cattolica del Sacro Cuore, Istituto di Clinica Ostetrica e Ginecologica, Rome, Italy
| | - P Bagolan
- Bambino Gesù Children's Hospital, Medical and Surgical Department of Foetus-Newborn-Infant, IRCCS, Rome, Italy
- Department of Systems Medicine, University of Rome 'Tor Vergata', Rome, Italy
| | - A C Testa
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
- Università Cattolica del Sacro Cuore, Istituto di Clinica Ostetrica e Ginecologica, Rome, Italy
| | - L Caforio
- Bambino Gesù Children's Hospital, Medical and Surgical Department of Foetus-Newborn-Infant, IRCCS, Rome, Italy
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Moro F, Scavello I, Maseroli E, Rastrelli G, Baima Poma C, Bonin C, Dassie F, Federici S, Fiengo S, Guccione L, Villani M, Gambineri A, Mioni R, Moghetti P, Moretti C, Persani L, Scambia G, Giorgino F, Vignozzi L. The physiological sonographic features of the ovary in healthy subjects: a joint systematic review and meta-analysis by the Italian Society of Gynecology and Obstetrics (SIGO) and the Italian Society of Endocrinology (SIE). J Endocrinol Invest 2023; 46:439-456. [PMID: 36422829 PMCID: PMC9938076 DOI: 10.1007/s40618-022-01939-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 10/11/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE There is a lack of uniformity in the definition of normal ovary ultrasound parameters. Our aim was to summarize and meta-analyze the evidence on the topic. Full-text English articles published through December 31, 2020 were retrieved via MEDLINE and Embase. Data available for meta-analysis included: ovarian follicular count, ovarian volume, and ovarian Pulsatility Index (PI) assessed by Doppler ultrasound. METHODS Cohort, cross-sectional, prospective studies with a single or double arm were considered eligible. Interventional studies were included when providing baseline data. Both studies on pre- and post-menopausal women were screened; however, data on menopausal women were not sufficient to perform a meta-analysis. Studies on pre-pubertal girls were considered separately. Eighty-one papers were included in the meta-analysis. RESULTS The mean ovarian volume was 6.11 [5.81-6.42] ml in healthy women in reproductive age (5.81-6.42) and 1.67 ml [1.02-2.32] in pre-pubertal girls. In reproductive age, the mean follicular count was 8.04 [7.26-8.82] when calculated in the whole ovary and 5.88 [5.20-6.56] in an ovarian section, and the mean ovarian PI was 1.86 [1.35-2.37]. Age and the frequency of the transducers partly modulated these values. In particular, the 25-30-year group showed the higher mean follicular count (9.27 [7.71-10.82]), followed by a progressive age-related reduction (5.67 [2.23-9.12] in fertile women > 35 years). A significant difference in follicular count was also found according to the transducer's upper MHz limit. CONCLUSION Our findings provide a significant input to improve the interpretation and diagnostic accuracy of ovarian ultrasound parameters in different physiological and pathological settings.
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Affiliation(s)
- F Moro
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
| | - I Scavello
- Department of Experimental Clinical and Biomedical Sciences "Mario Serio", University of Florence, Viale Pieraccini 6, 50134, Florence, Italy
| | - E Maseroli
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - G Rastrelli
- Department of Experimental Clinical and Biomedical Sciences "Mario Serio", University of Florence, Viale Pieraccini 6, 50134, Florence, Italy
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - C Baima Poma
- Consultorio Familiare ASL Città di Torino, Turin, Italy
| | - C Bonin
- Unit of Obstetrics and Gynecology B, Department of Women and Children's Health, AOUI Verona, Verona, Italy
| | - F Dassie
- Department of Medicine, Clinica Medica 3-Azienda Ospedaliera, University of Padua, Padua, Italy
| | - S Federici
- Unit of Andrology and Reproductive Endocrinology, Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, 20149, Milan, Italy
| | - S Fiengo
- Department of Obstetrics and Gynaecology, ARNAS Civico Hospital, Palermo, Italy
| | - L Guccione
- Department of Systems' Medicine, University of Tor Vergata, Rome, Italy
| | - M Villani
- Unit of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Verona, Verona, Italy
| | - A Gambineri
- Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - R Mioni
- Department of Medicine, Clinica Medica 3-Azienda Ospedaliera, University of Padua, Padua, Italy
| | - P Moghetti
- Unit of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Verona, Verona, Italy
| | - C Moretti
- Department of Systems' Medicine, University of Tor Vergata, Rome, Italy
| | - L Persani
- Unit of Andrology and Reproductive Endocrinology, Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, 20149, Milan, Italy
- Department of Medical Biotechnology and Translational Medicine, University of Milan, 20121, Milan, Italy
| | - G Scambia
- Istituto Di Clinica Ostetrica E Ginecologica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - F Giorgino
- Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, Department of Emergency and Organ Transplantation, University of Bari Aldo Moro, Bari, Italy
| | - L Vignozzi
- Department of Experimental Clinical and Biomedical Sciences "Mario Serio", University of Florence, Viale Pieraccini 6, 50134, Florence, Italy.
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
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Pira A, Sinagra JLM, Moro F, Mariotti F, Di Zenzo G. Autoimmune bullous diseases during COVID-19 pandemic: 2022 update on rituximab and vaccine. Front Med (Lausanne) 2023; 10:1112823. [PMID: 36744126 PMCID: PMC9893122 DOI: 10.3389/fmed.2023.1112823] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 01/04/2023] [Indexed: 01/20/2023] Open
Abstract
Autoimmune bullous diseases (AIBDs) are a heterogeneous group of life-threatening disorders associated with subepidermal or intraepidermal blistering. Skin barrier alterations and prolonged immunosuppressive treatments increase the risk of infections in patients with AIBDs, who are considered fragile. COVID-19 pandemic had a heavy impact on these patients. Although advances have been made in terms of prevention and treatment of COVID-19, this topic remains significant as the pandemic and its waves could last several years and, so far, a relevant proportion of the population worldwide is not vaccinated. This review is a 2022 update that summarizes and discusses the pandemic's burden on AIBD patients mainly considering relevant studies in terms of: (i) sample dimension; (ii) quality of control populations; (iii) possible standardization by age, gender and country. The findings show that: (i) the risk of COVID-19 infection and its severe course were comparable in AIBD patients and in the general population, except for rituximab-treated patients that presented a higher risk of infection and severe disease; (ii) the mortality rate in COVID-19-infected bullous pemphigoid patients was higher than in the general population, (iii) 121 cases of AIBD onset and 185 cases of relapse or exacerbation occurred after COVID-19 vaccination and a causal relationship has not been demonstrated so far. Altogether, acquired knowledge on COVID-19 pandemic could also be important in possible, albeit undesirable, future pandemic scenarios.
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Affiliation(s)
- Anna Pira
- Molecular and Cell Biology Laboratory, Istituto Dermopatico dell’Immacolata (IDI)-IRCCS, Rome, Italy
| | - Jo Linda Maria Sinagra
- Molecular and Cell Biology Laboratory, Istituto Dermopatico dell’Immacolata (IDI)-IRCCS, Rome, Italy,Dermatology Unit, Istituto Dermopatico dell’Immacolata (IDI)-IRCCS, Rome, Italy
| | - Francesco Moro
- Molecular and Cell Biology Laboratory, Istituto Dermopatico dell’Immacolata (IDI)-IRCCS, Rome, Italy,Dermatology Unit, Istituto Dermopatico dell’Immacolata (IDI)-IRCCS, Rome, Italy
| | - Feliciana Mariotti
- Molecular and Cell Biology Laboratory, Istituto Dermopatico dell’Immacolata (IDI)-IRCCS, Rome, Italy
| | - Giovanni Di Zenzo
- Molecular and Cell Biology Laboratory, Istituto Dermopatico dell’Immacolata (IDI)-IRCCS, Rome, Italy,*Correspondence: Giovanni Di Zenzo,
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15
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Moro F, Mariotti F, Pira A, De Luca N, Didona B, Pagnanelli G, Di Zenzo G. Case report: Bullous pemphigoid arising in a patient with scleroderma and multiple sclerosis. Front Med (Lausanne) 2022; 9:1055045. [PMID: 36569153 PMCID: PMC9773387 DOI: 10.3389/fmed.2022.1055045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 11/21/2022] [Indexed: 12/13/2022] Open
Abstract
Background Bullous pemphigoid (BP) is the most common autoimmune-blistering disease, clinically characterized by erythematous urticarial plaques, blisters, and intense pruritus, induced by autoantibodies against two proteins of the dermo-epidermal junction, BP180 and BP230. A large number of autoimmune diseases are reported in the literature as BP comorbidities, such as multiple sclerosis, but only a few cases are in association with scleroderma and none in association with both. Case presentation We present the case of a 68-year-old woman affected by multiple sclerosis and scleroderma who developed severe bullous pemphigoid with a bullous pemphigoid disease area index of 60 and high titers of anti-BP180 and anti-BP230 autoantibodies by enzyme-linked immunosorbent assays. After 2 months of therapy with both intravenous and oral corticosteroids, the active lesions of bullous pemphigoid were remitted with no relapse. Conclusion Autoimmune diseases affecting the skin or organs where BP180 and BP230 are present could trigger an immune response to these antigens through an epitope-spreading phenomenon and, over the years, induce bullous pemphigoid onset.
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Affiliation(s)
- Francesco Moro
- Dermatology Unit, Istituto Dermopatico dell’Immacolata (IDI)-IRCCS, Rome, Italy,Molecular and Cell Biology Laboratory, IDI-IRCCS, Rome, Italy
| | | | - Anna Pira
- Molecular and Cell Biology Laboratory, IDI-IRCCS, Rome, Italy
| | - Naomi De Luca
- Molecular and Cell Biology Laboratory, IDI-IRCCS, Rome, Italy
| | - Biagio Didona
- Dermatology Unit, Istituto Dermopatico dell’Immacolata (IDI)-IRCCS, Rome, Italy
| | - Gianluca Pagnanelli
- Dermatology Unit, Istituto Dermopatico dell’Immacolata (IDI)-IRCCS, Rome, Italy
| | - Giovanni Di Zenzo
- Molecular and Cell Biology Laboratory, IDI-IRCCS, Rome, Italy,*Correspondence: Giovanni Di Zenzo,
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16
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Moro F, Ciccone D, Fania L, Mariotti F, Salemme A, Rahimi S, Pallotta S, Di Zenzo G. Case report: A rare case of imiquimod-induced atypical pemphigus vulgaris. Front Med (Lausanne) 2022; 9:1054544. [PMID: 36507544 PMCID: PMC9729728 DOI: 10.3389/fmed.2022.1054544] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 11/08/2022] [Indexed: 11/25/2022] Open
Abstract
Background Pemphigus vulgaris is an autoimmune intraepithelial bullous disease involving the skin and the mucous membranes. Imiquimod, a topical therapy for skin basal cell carcinoma, is an amine that induces the production of tumor necrosis factor alfa, interleukin-1 and other cytokines. Pemphigus induced by drugs has been frequently reported, mostly after systemic therapy. Case presentation We present the case of a 50-year-old man who developed skin, intraoral, and genital mucosae lesions 3 days after a treatment with Imiquimod for multiple superficial basal cell carcinoma of the trunk. Direct and indirect immunofluorescence results were compatible with the diagnosis of pemphigus vulgaris. Enzyme-linked immunosorbent assay was negative for desmoglein 1 and 3, but interestingly, by immunoblotting on keratinocyte extracts a band of 170 kDa was obtained by IgG. The patient, after interrupting Imiquimod application, started a treatment with prednisolone and in 4 weeks showed a complete remission. Conclusion Topical Imiquimod therapy might induce atypical pemphigus vulgaris in some patients.
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Affiliation(s)
- Francesco Moro
- Dermatology Clinic, Istituto Dermopatico dell’Immacolata (IDI)-IRCCS, Rome, Italy,Molecular and Cell Biology Laboratory, Istituto Dermopatico dell’Immacolata (IDI)-IRCCS, Rome, Italy,*Correspondence: Francesco Moro,
| | - Davide Ciccone
- Dermatology Clinic, Istituto Dermopatico dell’Immacolata (IDI)-IRCCS, Rome, Italy
| | - Luca Fania
- Dermatology Clinic, Istituto Dermopatico dell’Immacolata (IDI)-IRCCS, Rome, Italy
| | - Feliciana Mariotti
- Molecular and Cell Biology Laboratory, Istituto Dermopatico dell’Immacolata (IDI)-IRCCS, Rome, Italy
| | - Adele Salemme
- Molecular and Cell Biology Laboratory, Istituto Dermopatico dell’Immacolata (IDI)-IRCCS, Rome, Italy
| | - Siavash Rahimi
- Department of Anatomic Pathology, Istituto Dermopatico dell’Immacolata (IDI)-IRCCS, Rome, Italy
| | - Sabatino Pallotta
- Dermatology Clinic, Istituto Dermopatico dell’Immacolata (IDI)-IRCCS, Rome, Italy
| | - Giovanni Di Zenzo
- Molecular and Cell Biology Laboratory, Istituto Dermopatico dell’Immacolata (IDI)-IRCCS, Rome, Italy
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Ferrari P, Contessa GM, Moro F, Gadani G, Lepore L, Pietropaolo A. SORGENTINA-RF FUSION NEUTRON PLANT: PRELIMINARY DESIGN OF THE BIOSHIELDING IN COMPLIANCE WITH DOSE CONSTRAINTS FOR WORKERS EXPOSURE. Radiat Prot Dosimetry 2022; 198:1409-1416. [PMID: 36083112 DOI: 10.1093/rpd/ncac175] [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] [Received: 05/16/2022] [Revised: 07/27/2022] [Accepted: 07/28/2022] [Indexed: 06/15/2023]
Abstract
An accelerator-driven 14 MeV neutron source of new concept, denominated SORGENTINA-RF, will be installed in ENEA Brasimone Research Centre, to test the feasibility of producing radionuclides of medical relevance using fusion neutrons. The main goal of the facility is generating 99Mo as precursor of 99mTc, a radionuclide widely used in nuclear medicine diagnostic procedures, using the 14 MeV fusion neutrons produced by the plant. This work describes the study performed for the design of a proper shielding structure that aims at fulfilling the requirement of 0.01 mSv/h dose rate limit on the external surface of the shielding during beam-on operations. The proposed shielding consists of a layered structure composed of 2 m standard concrete and 1 m baritic concrete. The design is still in the preliminary phase to assess the feasibility and the economic issues as well as structural impact of the shielding structure.
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Affiliation(s)
- P Ferrari
- ENEA-Radiation Protection Institute, 4, Via Martiri di Monte Sole, 40129, Bologna, (BO), Italy
| | - G M Contessa
- ENEA- Department of Fusion and Technologies for Nuclear Safety and Security, 00123, S. Maria di Galeria, Rome, (Italy)
| | - F Moro
- ENEA- Department of Fusion and Technologies for Nuclear Safety and Security, 00123, S. Maria di Galeria, Rome, (Italy)
| | - G Gadani
- ENEA- Department of Fusion and Technologies for Nuclear Safety and Security, 00123, S. Maria di Galeria, Rome, (Italy)
| | - L Lepore
- ENEA- Department of Fusion and Technologies for Nuclear Safety and Security, 00123, S. Maria di Galeria, Rome, (Italy)
| | - A Pietropaolo
- ENEA- Department of Fusion and Technologies for Nuclear Safety and Security, 00123, S. Maria di Galeria, Rome, (Italy)
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18
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Heremans R, Valentin L, Sladkevicius P, Timmerman S, Moro F, Van Holsbeke C, Epstein E, Testa AC, Timmerman D, Froyman W. Imaging in gynecological disease (24): clinical and ultrasound characteristics of ovarian mature cystic teratomas. Ultrasound Obstet Gynecol 2022; 60:549-558. [PMID: 35316568 DOI: 10.1002/uog.24904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 02/16/2022] [Accepted: 03/14/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To describe the clinical and ultrasound features of ovarian mature cystic teratomas (MCTs). METHODS This was a retrospective study. From the International Ovarian Tumor Analysis (IOTA) database, we identified patients with a histologically confirmed diagnosis of MCT who had undergone transvaginal ultrasound examination between 1999 and 2016 (IOTA phases 1, 2, 3 and 5) in one of five centers. Ultrasound was performed by an experienced examiner who used the standardized IOTA examination technique and terminology. In addition to extracting data from the IOTA database, available two-dimensional grayscale and color or power Doppler images were reviewed retrospectively to identify typical ultrasound features of MCT described previously and detect possible new features using pattern recognition. All images were reviewed by two independent examiners and further discussed with two ultrasound experts to reach consensus. RESULTS Included in the study were 454 patients with histologically confirmed MCT. Median age was 33 (range, 8-90) years and 66 (14.5%) patients were postmenopausal. Most MCTs were described by the original ultrasound examiner as unilocular (262/454 (57.7%)) or multilocular (70/454 (15.4%)) cysts with mixed echogenicity of cystic fluid (368/454 (81.1%)), acoustic shadowing (328/454 (72.2%)) and no or little vascularization on color Doppler (color score 1, 240/454 (52.9%); color score 2, 123/454 (27.1%)). The median largest lesion diameter was 66 (range, 15-310) mm. A correct preoperative diagnosis of MCT was suggested by the original ultrasound examiner in 372/454 (81.9%) cases. On retrospective review of ultrasound images of 334 MCTs that had quality sufficient for assessment, 'dots and/or lines' and/or 'echogenic white ball' (typical features according to the literature) were present in 271/334 (81.1%) masses. We identified four new ultrasound features characteristic of MCT: 'cotton wool tufts', 'mushroom cap sign', 'completely hyperechogenic lesion' and 'starry sky sign'. At least one classical or novel ultrasound feature was present in 315/334 (94.3%) MCTs. Twenty-nine (8.7%) MCTs manifested vascularized solid tissue, of which seven exhibited no typical features. CONCLUSION We provide a comprehensive overview of conventional and newly described ultrasound features of MCTs. Only a small proportion of MCTs did not manifest any of the typical features. © 2022 International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- R Heremans
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
- Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium
| | - L Valentin
- Department of Obstetrics and Gynecology, Skåne University Hospital, Malmö, Sweden
- Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - P Sladkevicius
- Department of Obstetrics and Gynecology, Skåne University Hospital, Malmö, Sweden
| | - S Timmerman
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
- Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium
| | - F Moro
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCSS, Rome, Italy
| | - C Van Holsbeke
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
- Department of Obstetrics and Gynecology, Ziekenhuis Oost-Limburg, Genk, Belgium
| | - E Epstein
- Department of Obstetrics and Gynecology, Södersjukhuset, Stockholm, Sweden
- Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden
| | - A C Testa
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCSS, Rome, Italy
| | - D Timmerman
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
- Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium
| | - W Froyman
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
- Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium
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19
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Moro F, Boldrini L, Lenkowicz J, Scambia G, Testa AC, Fanfani F. Reply. Ultrasound Obstet Gynecol 2022; 60:299-300. [PMID: 35913380 DOI: 10.1002/uog.24963] [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] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Affiliation(s)
- F Moro
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
| | - L Boldrini
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, UOC Radioterapia Oncologica, Rome, Italy
| | - J Lenkowicz
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, UOC Radioterapia Oncologica, Rome, Italy
| | - G Scambia
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
- Università Cattolica del Sacro Cuore, Istituto di Clinica Ostetrica e Ginecologica, Rome, Italy
| | - A C Testa
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
- Università Cattolica del Sacro Cuore, Istituto di Clinica Ostetrica e Ginecologica, Rome, Italy
| | - F Fanfani
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
- Università Cattolica del Sacro Cuore, Istituto di Clinica Ostetrica e Ginecologica, Rome, Italy
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20
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Bardazzi F, Filippi F, Chessa MA, Iommi M, Loi C, Campanati A, Rizzetto G, Tagliati C, Atzori L, Muratori S, Genovese G, Gisondi P, Schena D, Balestri R, Rech G, Feliciani C, Lasagni C, Bigi L, De Simone C, Di Zenzo G, Moro F, Borghi A, Di Lernia V, D'Arrigo G, Tripepi G, Gori M, Pitino A. Mortality and prognostic factors in patients with bullous pemphigoid: a retrospective multicenter Italian study. J Eur Acad Dermatol Venereol 2022; 36:2473-2481. [PMID: 35857348 DOI: 10.1111/jdv.18441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 06/14/2022] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Bullous pemphigoid is the most common autoimmune bullous dermatosis. In recent years several studies have tried to identify the main factors of the disease related with an increased risk of death. The aim of this multicenter Italian study was to assess the risk score of death considering epidemiologic, clinical, immunological, and therapeutic factors in a cohort of patients affected by bullous pemphigoid and try to identify the cumulative survival up to 120 months. METHODS We retrospectively reviewed the medical records of patients with bullous pemphigoid who were diagnosed between 2005 and 2020 in the 12 Italian centers. Data collected included sex, age at the time of diagnosis, laboratory findings, severity of disease, time at death/censoring, treatment, and multimorbidity. RESULTS A total of 572 patients were included in the study. The crude mortality rate was of 20.6%, with an incidence mortality rate of 5.9x100 person/year. The mortality rate at 1,3,5 and 10 years was 3,2%, 18,2%, 27,4% and 51,9%, respectively. Multivariate model results showed that the risk of death was significantly higher in patients older than 78 years, in presence of multimorbidity, anti-BP180 autoantibodies>72 U/ml or anti-BP230>3 U/ml at diagnosis. The variables jointly included provided an accuracy (Harrel's Index) of 77% for predicting mortality. CONCLUSION This study represents the first nationwide Italian study to have retrospectively investigated the mortality rates and prognostic factors in patients with bullous pemphigoid. A novel finding emerged in our study is that a risk prediction rule based on simple risk factors (age, multimorbidity, steroid-sparing drugs, prednisone use and disease severity) jointly considered with two biomarkers routinely measured in clinical practice (anti-BP230 and anti-BP180 autoantibodies) provided about 80% accuracy for predicting mortality in large series of patients with this disease.
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Affiliation(s)
- Federico Bardazzi
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, Division of Dermatology, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.,Division of Dermatology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Federica Filippi
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, Division of Dermatology, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.,Division of Dermatology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Marco Adriano Chessa
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, Division of Dermatology, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.,Division of Dermatology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Marica Iommi
- Department of Biomedical and Neuromotor Sciences, University of Bologna
| | - Camilla Loi
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, Division of Dermatology, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.,Division of Dermatology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Anna Campanati
- Dermatology Clinic, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Giulio Rizzetto
- Dermatology Clinic, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Corrado Tagliati
- Dermatology Clinic, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Laura Atzori
- Dermatology Clinic, Department of Medical Sciences and Public Health, University of Cagliari
| | - Simona Muratori
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giovanni Genovese
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Paolo Gisondi
- Section of Dermatology, Department of Medicine, University of Verona, 37126, Verona, Italy
| | - Donatella Schena
- Section of Dermatology, Department of Medicine, University of Verona, 37126, Verona, Italy
| | | | - Giulia Rech
- Division of Dermatology, Santa Chiara Hospital, Trento, Italy
| | - Claudio Feliciani
- Section of Dermatology, Department of Medicine and Surgery, University of Parma, Italy
| | - Claudia Lasagni
- Dermatology Unit, Surgical, Medical, and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Laura Bigi
- Dermatology Unit, Surgical, Medical, and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Clara De Simone
- Institute of Dermatology, University Hospital "A. Gemelli", Catholic University of the Sacred Heart, Rome, Italy.,Department of Dermatology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giovanni Di Zenzo
- Laboratory of Molecular and Cell Biology, Istituto Dermopatico dell'Immacolata (IDI)-IRCCS, Rome, Italy
| | - Francesco Moro
- Laboratory of Molecular and Cell Biology, Istituto Dermopatico dell'Immacolata (IDI)-IRCCS, Rome, Italy
| | - Alessandro Borghi
- Department of Medical Sciences, Section of Dermatology and Infectious Diseases University of Ferrara, Ferrara, Italy
| | - Vito Di Lernia
- Dermatology Unit, Department of Medical Specialities, Dermatology Unit, Arcispedale Santa Maria Nuova, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | - Giovanni Tripepi
- IFC CNR Institute of clinical physiology of Reggio Calabria, Italy
| | - Mercedes Gori
- IFC CNR Institute of clinical physiology of Rome, Italy
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21
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Maronese CA, Caproni M, Moltrasio C, Genovese G, Vezzoli P, Sena P, Previtali G, Cozzani E, Gasparini G, Parodi A, Atzori L, Antiga E, Maglie R, Moro F, Mariotti EB, Corrà A, Pallotta S, Didona B, Marzano AV, Di Zenzo G. Bullous Pemphigoid Associated With COVID-19 Vaccines: An Italian Multicentre Study. Front Med (Lausanne) 2022; 9:841506. [PMID: 35295599 PMCID: PMC8918943 DOI: 10.3389/fmed.2022.841506] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 02/03/2022] [Indexed: 01/06/2023] Open
Abstract
Bullous pemphigoid (BP) is an autoimmune bullous disease caused by circulating autoantibodies toward the hemidesmosomal antigens BP180 and BP230. Cases of BP have been described following vaccinations against tetanus, poliomyelitis, diphtheria, influenza, pneumococcus, meningococcus, hepatitis B and rabies. The putative mechanism by which COVID-19-vaccines may induce BP has not been clarified. An Italian multicentre study was conducted to collect clinical, histopathological and immunopathological data of patients with BP associated with COVID-19-vaccines. Twenty-one cases were collected, including 9 females and 12 males (M/F = 1.3) with a median age at diagnosis of 82 years. Seventeen patients received the COMIRNATY Pfizer-BioNTech vaccine, two the Moderna mRNA-1273 vaccine, one the ChAdOx1/nCoV-19-AstraZeneca/ Vaxzevria vaccine and one received the first dose with the ChAdOx1/nCoV-19-AstraZeneca/Vaxzevria vaccine and the second dose with the COMIRNATY Pfizer-BioNTech vaccine. Median latency time between the first dose of anti-SARS-CoV-2 vaccine and the onset of cutaneous manifestations was 27 days. Median BPDAI at onset was 42. Eleven out of seventeen patients (65%) had positive titres for anti-BP180 antibodies with a median value of 106.3 U/mL on ELISA; in contrast, only five out of seventeen (29%) were positive for anti-BP230 antibodies, with a median of 35.3 U/mL. In conclusion, in terms of mean age, disease severity at diagnosis and clinical phenotype vaccine-associated BP patients seem to be similar to idiopathic BP with an overall benign course with appropriate treatment. On the other hand, the slight male predominance and the reduced humoral response to BP230 represent peculiar features of this subset of patients.
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Affiliation(s)
- Carlo Alberto Maronese
- Dermatology Unit, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Marzia Caproni
- Rare Diseases Unit, Section of Dermatology, Department of Health Sciences, Unità Sanitaria Locale Toscana Centro, European Reference Network-Skin Member, University of Florence, Florence, Italy
| | - Chiara Moltrasio
- Dermatology Unit, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy,Department of Medical Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Giovanni Genovese
- Dermatology Unit, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Pamela Vezzoli
- Dermatology Unit, Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Paolo Sena
- Dermatology Unit, Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Giulia Previtali
- Clinical Chemistry Laboratory, Department of Clinical Pathology, Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Emanuele Cozzani
- DiSSal, Dermatology Clinic, University of Genoa, San Martino Policlinic Hospital- Istituto di Ricovero e Cura a Carattere Scientifico, Genoa, Italy
| | - Giulia Gasparini
- DiSSal, Dermatology Clinic, University of Genoa, San Martino Policlinic Hospital- Istituto di Ricovero e Cura a Carattere Scientifico, Genoa, Italy
| | - Aurora Parodi
- DiSSal, Dermatology Clinic, University of Genoa, San Martino Policlinic Hospital- Istituto di Ricovero e Cura a Carattere Scientifico, Genoa, Italy
| | - Laura Atzori
- Dermatology Clinic, Department Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Emiliano Antiga
- Department of Health Sciences, Section of Dermatology, University of Florence, Florence, Italy
| | - Roberto Maglie
- Department of Health Sciences, Section of Dermatology, University of Florence, Florence, Italy
| | - Francesco Moro
- Molecular and Cell Biology Laboratory, Istituto Dermopatico dell'Immacolata - Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
| | | | - Alberto Corrà
- Department of Health Sciences, Section of Dermatology, University of Florence, Florence, Italy
| | - Sabatino Pallotta
- Dermatology Clinic, Istituto Dermopatico dell'Immacolata - Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
| | - Biagio Didona
- Rare Disease Unit, Istituto Dermopatico dell'Immacolata - Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
| | - Angelo Valerio Marzano
- Dermatology Unit, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Giovanni Di Zenzo
- Molecular and Cell Biology Laboratory, Istituto Dermopatico dell'Immacolata - Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy,*Correspondence: Giovanni Di Zenzo
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22
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Ciccarone F, Biscione A, Moro F, Fischerova D, Savelli L, Munaretto M, Jokubkiene L, Sladkevicius P, Chiappa V, Fruscio R, Franchi D, Epstein E, Timmerman D, Froyman W, Valentin L, Scambia G, Testa AC. Imaging in gynecological disease (23): clinical and ultrasound characteristics of ovarian carcinosarcoma. Ultrasound Obstet Gynecol 2022; 59:241-247. [PMID: 34225386 DOI: 10.1002/uog.23733] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 06/22/2021] [Accepted: 06/23/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To describe the clinical and ultrasound characteristics of ovarian carcinosarcoma. METHODS This was a retrospective multicenter study. Patients with a histological diagnosis of ovarian carcinosarcoma, who had undergone preoperative ultrasound examination between 2010 and 2019, were identified from the International Ovarian Tumor Analysis (IOTA) database. Additional patients who were examined outside of the IOTA study were identified from the databases of the participating centers. The masses were described using the terms and definitions of the IOTA group. Additionally, two experienced ultrasound examiners reviewed all available images to identify typical ultrasound features using pattern recognition. RESULTS Ninety-one patients with ovarian carcinosarcoma who had undergone ultrasound examination were identified, of whom 24 were examined within the IOTA studies and 67 were examined outside of the IOTA studies. Median age at diagnosis was 66 (range, 33-91) years and 84/91 (92.3%) patients were postmenopausal. Most patients (67/91, 73.6%) were symptomatic, with the most common complaint being pain (51/91, 56.0%). Most tumors (67/91, 73.6%) were International Federation of Gynecology and Obstetrics (FIGO) Stage III or IV. Bilateral lesions were observed on ultrasound in 46/91 (50.5%) patients. Ascites was present in 38/91 (41.8%) patients. The median largest tumor diameter was 100 (range, 18-260) mm. All ovarian carcinosarcomas contained solid components, and most were described as solid (66/91, 72.5%) or multilocular-solid (22/91, 24.2%). The median diameter of the largest solid component was 77.5 (range, 11-238) mm. Moderate or rich vascularization was found in 78/91 (85.7%) cases. Retrospective analysis of ultrasound images and videoclips using pattern recognition in 73 cases revealed that all tumors had irregular margins and inhomogeneous echogenicity of the solid components. Forty-seven of 73 (64.4%) masses appeared as a solid tumor with cystic areas. Cooked appearance of the solid tissue was identified in 28/73 (38.4%) tumors. No pathognomonic ultrasound sign of ovarian carcinosarcoma was found. CONCLUSIONS Ovarian carcinosarcomas are usually diagnosed in postmenopausal women and at an advanced stage. The most common ultrasound appearance is a large solid tumor with irregular margins, inhomogeneous echogenicity of the solid tissue and cystic areas. The second most common pattern is a large multilocular-solid mass with inhomogeneous echogenicity of the solid tissue. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- F Ciccarone
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - A Biscione
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - F Moro
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - D Fischerova
- Department of Obstetrics and Gynecology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - L Savelli
- Gynecologic and Obstetric Unit, Women's and Children's Department, Forlì Hospital, Forlì, Italy
| | - M Munaretto
- Department of Obstetrics and Gynecology, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - L Jokubkiene
- Department of Obstetrics and Gynecology, Skåne University Hospital, Malmö, Sweden
- Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - P Sladkevicius
- Department of Obstetrics and Gynecology, Skåne University Hospital, Malmö, Sweden
- Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - V Chiappa
- Department of Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy
| | - R Fruscio
- Clinic of Obstetrics and Gynecology, University of Milano-Bicocca, Department of Medicine and Surgery, San Gerardo Hospital, Monza, Italy
| | - D Franchi
- Gynecologic Oncology Unit, Division of Gynecology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - E Epstein
- Department of Obstetrics and Gynecology, Karolinska University Hospital, Stockholm, Sweden
| | - D Timmerman
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
- Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium
| | - W Froyman
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
- Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium
| | - L Valentin
- Department of Obstetrics and Gynecology, Skåne University Hospital, Malmö, Sweden
- Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - G Scambia
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
- Dipartimento Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - A C Testa
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
- Dipartimento Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
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23
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Moro F, Bertoldo V, Avesani G, Moruzzi MC, Mascilini F, Bolomini G, Caliolo G, Esposito R, Moroni R, Zannoni GF, Fagotti A, Manfredi R, Scambia G, Testa AC. Fusion imaging in preoperative assessment of extent of disease in patients with advanced ovarian cancer: feasibility and agreement with laparoscopic findings. Ultrasound Obstet Gynecol 2021; 58:916-925. [PMID: 33847427 DOI: 10.1002/uog.23650] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 03/19/2021] [Accepted: 03/30/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVES Fusion imaging is an emerging technique that combines real-time ultrasound examination with images acquired previously using other modalities, such as computed tomography (CT), magnetic resonance imaging and positron emission tomography. The primary aim of this study was to evaluate the feasibility of fusion imaging in patients with suspicion of ovarian or peritoneal cancer. Secondary aims were: to compare the agreement of findings on fusion imaging, CT alone and ultrasound imaging alone with laparoscopic findings, in the assessment of extent of intra-abdominal disease; and to evaluate the time required for the fusion imaging technique. METHODS Patients with clinical and/or radiographic suspicion of advanced ovarian or peritoneal cancer who were candidates for surgery were enrolled prospectively between December 2019 and September 2020. All patients underwent a CT scan and ultrasound and fusion imaging to evaluate the presence or absence of the following abdominal-cancer features according to the laparoscopy-based scoring model (predictive index value (PIV)): supracolic omental disease, visceral carcinomatosis on the liver, lesser omental carcinomatosis and/or visceral carcinomatosis on the lesser curvature of the stomach and/or spleen, involvement of the paracolic gutter(s) and/or anterior abdominal wall, involvement of the diaphragm and visceral carcinomatosis on the small and/or large bowel (regardless of rectosigmoid involvement). The feasibility of the fusion examination in these patients was evaluated. Agreement of each imaging method (ultrasound, CT and fusion imaging) with laparoscopy (considered as reference standard) was calculated using Cohen's kappa coefficient. RESULTS Fifty-two patients were enrolled into the study. Fusion imaging was feasible in 51 (98%) of these patients (in one patient, it was not possible for technical reasons). Two patients were excluded because laparoscopy was not performed, leaving 49 women in the final analysis. Kappa values for CT, ultrasound and fusion imaging, using laparoscopy as the reference standard, in assessing the PIV parameters were, respectively: 0.781, 0.845 and 0.896 for the great omentum; 0.329, 0.608 and 0.847 for the liver surface; 0.472, 0.549 and 0.756 for the lesser omentum and/or stomach and/or spleen; 0.385, 0.588 and 0.795 for the paracolic gutter(s) and/or anterior abdominal wall; 0.385, 0.497 and 0.657 for the diaphragm; and 0.336, 0.410 and 0.469 for the bowel. The median time needed to perform the fusion examination was 20 (range, 10-40) min. CONCLUSION Fusion of CT images and real-time ultrasound imaging is feasible in patients with suspicion of ovarian or peritoneal cancer and improves the agreement with surgical findings when compared with ultrasound or CT scan alone. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- F Moro
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
| | - V Bertoldo
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
| | - G Avesani
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Rome, Italy
| | - M C Moruzzi
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
| | - F Mascilini
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
| | - G Bolomini
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
| | - G Caliolo
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Rome, Italy
| | - R Esposito
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
| | - R Moroni
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Direzione Scientifica, Rome, Italy
| | - G F Zannoni
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
- Istituto di Anatomia Patologica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - A Fagotti
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
- Università Cattolica del Sacro Cuore, Dipartimento Scienze della Vita e di Sanità Pubblica, Rome, Italy
| | - R Manfredi
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Rome, Italy
- Istituto di Radiologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - G Scambia
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
- Università Cattolica del Sacro Cuore, Dipartimento Scienze della Vita e di Sanità Pubblica, Rome, Italy
| | - A C Testa
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
- Università Cattolica del Sacro Cuore, Dipartimento Scienze della Vita e di Sanità Pubblica, Rome, Italy
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24
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Moro F, Bertoldo V, Avesani G, Moruzzi MC, Mascilini F, Bolomini G, Caliolo G, Esposito R, Moroni R, Zannoni GF, Fagotti A, Manfredi R, Scambia G, Testa AC. Fusion imaging in preoperative assessment of extent of disease in patients with advanced ovarian cancer: feasibility and agreement with laparoscopic findings. Ultrasound Obstet Gynecol 2021; 60:256-268. [PMID: 33847427 DOI: 10.1002/uog.24805] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 10/07/2021] [Accepted: 10/13/2021] [Indexed: 05/25/2023]
Abstract
OBJECTIVES Fusion imaging is an emerging technique that combines real-time ultrasound examination with images acquired previously using other modalities, such as computed tomography (CT), magnetic resonance imaging and positron emission tomography. The primary aim of this study was to evaluate the feasibility of fusion imaging in patients with suspicion of ovarian or peritoneal cancer. Secondary aims were: to compare the agreement of findings on fusion imaging, CT alone and ultrasound imaging alone with laparoscopic findings, in the assessment of extent of intra-abdominal disease; and to evaluate the time required for the fusion imaging technique. METHODS Patients with clinical and/or radiographic suspicion of advanced ovarian or peritoneal cancer who were candidates for surgery were enrolled prospectively between December 2019 and September 2020. All patients underwent a CT scan and ultrasound and fusion imaging to evaluate the presence or absence of the following abdominal-cancer features according to the laparoscopy-based scoring model (predictive index value (PIV)): supracolic omental disease, visceral carcinomatosis on the liver, lesser omental carcinomatosis and/or visceral carcinomatosis on the lesser curvature of the stomach and/or spleen, involvement of the paracolic gutter(s) and/or anterior abdominal wall, involvement of the diaphragm and visceral carcinomatosis on the small and/or large bowel (regardless of rectosigmoid involvement). The feasibility of the fusion examination in these patients was evaluated. Agreement of each imaging method (ultrasound, CT and fusion imaging) with laparoscopy (considered as reference standard) was calculated using Cohen's kappa coefficient. RESULTS Fifty-two patients were enrolled into the study. Fusion imaging was feasible in 51 (98%) of these patients (in one patient, it was not possible for technical reasons). Two patients were excluded because laparoscopy was not performed, leaving 49 women in the final analysis. Kappa values for CT, ultrasound and fusion imaging, using laparoscopy as the reference standard, in assessing the PIV parameters were, respectively: 0.781, 0.845 and 0.896 for the great omentum; 0.329, 0.608 and 0.847 for the liver surface; 0.472, 0.549 and 0.756 for the lesser omentum and/or stomach and/or spleen; 0.385, 0.588 and 0.795 for the paracolic gutter(s) and/or anterior abdominal wall; 0.385, 0.497 and 0.657 for the diaphragm; and 0.336, 0.410 and 0.469 for the bowel. The median time needed to perform the fusion examination was 20 (range, 10-40) min. CONCLUSION Fusion of CT images and real-time ultrasound imaging is feasible in patients with suspicion of ovarian or peritoneal cancer and improves the agreement with surgical findings when compared with ultrasound or CT scan alone. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- F Moro
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
| | - V Bertoldo
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
| | - G Avesani
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Rome, Italy
| | - M C Moruzzi
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
| | - F Mascilini
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
| | - G Bolomini
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
| | - G Caliolo
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Rome, Italy
| | - R Esposito
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
| | - R Moroni
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Direzione Scientifica, Rome, Italy
| | - G F Zannoni
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
- Istituto di Anatomia Patologica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - A Fagotti
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
- Università Cattolica del Sacro Cuore, Dipartimento Scienze della Vita e di Sanità Pubblica, Rome, Italy
| | - R Manfredi
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Rome, Italy
- Istituto di Radiologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - G Scambia
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
- Università Cattolica del Sacro Cuore, Dipartimento Scienze della Vita e di Sanità Pubblica, Rome, Italy
| | - A C Testa
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
- Università Cattolica del Sacro Cuore, Dipartimento Scienze della Vita e di Sanità Pubblica, Rome, Italy
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Garganese G, Bove S, Fragomeni S, Moro F, Triumbari EKA, Collarino A, Verri D, Gentileschi S, Sperduti I, Scambia G, Rufini V, Testa AC. Real-time ultrasound virtual navigation in 3D PET/CT volumes for superficial lymph-node evaluation: innovative fusion examination. Ultrasound Obstet Gynecol 2021; 58:766-772. [PMID: 33587289 DOI: 10.1002/uog.23613] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 01/11/2021] [Accepted: 02/05/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To evaluate the feasibility and clinical application of fusion imaging with virtual navigation, combining 18 F-fluorodeoxyglucose (18 F-FDG) positron emission tomography/computed tomography (PET/CT) with real-time ultrasound imaging, in assessing superficial lymph nodes in breast-cancer and gynecological-cancer patients. METHODS This was a pilot study of breast- and gynecological-cancer patients with abnormal uptake of 18 F-FDG by axillary or groin lymph nodes on PET/CT scan, examined at our institution between January 2017 and May 2019. Fusion imaging was performed, uploading preacquired PET/CT DICOM images onto the ultrasound machine and synchronizing them with real-time ultrasound scanning performed at the lymph-node site. In the first phase, we assessed the feasibility and reliability of fusion imaging in a series of 10 patients with suspicious lymph nodes on both PET/CT and ultrasound, and with full correspondence between both techniques in terms of size, shape and morphology of the lymph nodes (Group A). In the second phase, we included 20 patients with non-corresponding findings between PET/CT and ultrasound: 10 patients with lymph nodes that were suspicious or pathological on PET/CT scan but not suspicious on ultrasound assessment (Group B), and 10 patients with suspicious or pathological lymph nodes on both PET/CT and ultrasound but with no correspondence between the two techniques in terms of number of affected lymph nodes (Group C). RESULTS In the 30 selected patients, fusion imaging was assessed at 30 lymph-node sites (22 inguinal and eight axillary nodes). In the first phase (Group A), the fusion technique was shown to be feasible in all 10 lymph-node sites evaluated. In the second phase, fusion imaging was completed successfully in nine of 10 cases in Group B and in all 10 cases in Group C. In all groups, fusion imaging was able to identify the target lymph node, guiding the examiner to perform a core-needle aspiration biopsy or to inject radiotracer for selective surgical nodal excision, according to the radio-guided occult lesion localization technique. CONCLUSION Fusion imaging with virtual navigation, combining PET/CT and real-time ultrasound imaging, is technically feasible and able to detect target lymph nodes even when PET/CT and ultrasound findings are inconsistent. Fusion imaging can also be used to guide the performance of core-needle aspiration biopsy, avoiding further surgical diagnostic procedures, or the injection of radiotracer for selective surgical nodal excision, enabling more sparing, selective surgery. This innovative technique could open up multiple diagnostic and therapeutic opportunities in breast and gynecological oncology. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- G Garganese
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Gynecology and Breast Care Center, Mater Olbia Hospital, Olbia, Italy
| | - S Bove
- Gynecology and Breast Care Center, Mater Olbia Hospital, Olbia, Italy
| | - S Fragomeni
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - F Moro
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - E K A Triumbari
- Istituto di Medicina Nucleare, Università Cattolica del Sacro Cuore, Rome, Italy
| | - A Collarino
- UOC di Medicina Nucleare, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - D Verri
- Gynecology and Breast Care Center, Mater Olbia Hospital, Olbia, Italy
| | - S Gentileschi
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Istituto di Clinica Chirurgica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - I Sperduti
- Department of Biostatistics, Regina Elena National Cancer Institute, IRCCS, Rome, Italy
| | - G Scambia
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Dipartimento Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - V Rufini
- Istituto di Medicina Nucleare, Università Cattolica del Sacro Cuore, Rome, Italy
- UOC di Medicina Nucleare, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - A C Testa
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Dipartimento Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
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Colangeli A, Flammini D, Fonnesu N, Garavaglia S, Granucci G, Luis R, Mariano G, Moro F, Romano A, Remetti R, Villari R. Neutron streaming analyses and shielding optimization through ECRH openings in DTT Tokamak building. Fusion Engineering and Design 2021. [DOI: 10.1016/j.fusengdes.2021.112690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Bolomini G, Moruzzi MC, Moro F, Lavecchia D, Esposito R, Scambia G, Testa AC. Repeat twisting of ovary in young woman with ribbon-like contralateral ovary and absence of contralateral Fallopian tube. Ultrasound Obstet Gynecol 2021; 58:491-492. [PMID: 33206438 DOI: 10.1002/uog.23543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 10/16/2020] [Accepted: 11/06/2020] [Indexed: 06/11/2023]
Affiliation(s)
- G Bolomini
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - M C Moruzzi
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - F Moro
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - D Lavecchia
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - R Esposito
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - G Scambia
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
- Dipartimento Scienze della Vita e Sanità pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - A C Testa
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
- Dipartimento Scienze della Vita e Sanità pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
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Moretta G, Moro F, Fania L, Didona B. Generalized acquired cutis laxa and urticarial dermatosis associated with k-chain IgA micromolecular myeloma. Dermatol Reports 2021; 13:9146. [PMID: 34497701 PMCID: PMC8404424 DOI: 10.4081/dr.2021.9146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 04/22/2021] [Indexed: 11/23/2022] Open
Affiliation(s)
- Gaia Moretta
- IDI-IRCCS, Dermatological Research Hospital, Rome, Italy
| | - Francesco Moro
- IDI-IRCCS, Dermatological Research Hospital, Rome, Italy
| | - Luca Fania
- IDI-IRCCS, Dermatological Research Hospital, Rome, Italy
| | - Biagio Didona
- IDI-IRCCS, Dermatological Research Hospital, Rome, Italy
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Moro F, Arena P, Catanzaro I, Colangeli A, Del Nevo A, Flammini D, Fonnesu N, Forte R, Imbriani V, Mariano G, Mozzillo R, Noce S, Villari R. Nuclear performances of the water-cooled lithium lead DEMO reactor: Neutronic analysis on a fully heterogeneous model. Fusion Engineering and Design 2021. [DOI: 10.1016/j.fusengdes.2021.112514] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Moro F, Castellano LM, Franchi D, Epstein E, Fischerova D, Froyman W, Timmerman D, Zannoni GF, Scambia G, Valentin L, Testa AC, Mascilini F. Imaging in gynecological disease (22): clinical and ultrasound characteristics of ovarian embryonal carcinomas, non-gestational choriocarcinomas and malignant mixed germ cell tumors. Ultrasound Obstet Gynecol 2021; 57:987-994. [PMID: 33142349 DOI: 10.1002/uog.23529] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 10/08/2020] [Accepted: 10/21/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To describe the clinical and ultrasound characteristics of three types of rare malignant ovarian germ cell tumor: embryonal carcinoma, non-gestational choriocarcinoma and malignant mixed germ cell tumor. METHODS This was a retrospective multicenter study. From the International Ovarian Tumor Analysis (IOTA) database, we identified patients with a histological diagnosis of ovarian embryonal carcinoma, non-gestational choriocarcinoma or malignant mixed germ cell tumor, who had undergone preoperative ultrasound examination by an experienced ultrasound examiner between 2000 and 2020. Additional patients with the same histology were identified from the databases of the departments of gynecological oncology in the participating centers. All tumors were described using IOTA terminology. Three examiners reviewed all available ultrasound images and described them using pattern recognition. RESULTS One patient with embryonal carcinoma, five patients with non-gestational ovarian choriocarcinoma and seven patients with ovarian malignant mixed germ cell tumor (six primary tumors and one recurrence) were identified. Seven patients were included in the IOTA studies and six patients were examined outside of the IOTA studies. The median age at diagnosis was 26 (range, 14-77) years. Beta-human chorionic gonadotropin levels were highest in non-gestational choriocarcinomas and alpha-fetoprotein levels were highest in malignant mixed germ cell tumors. Most tumors were International Federation of Gynecology and Obstetrics (FIGO) Stage I (9/12 (75.0%)). All tumors were unilateral, and the median largest diameter was 129 (range, 38-216) mm. Of the tumors, 11/13 (84.6%) were solid and 2/13 (15.4%) were multilocular-solid; 9/13 (69.2%) manifested abundant vascularization on color Doppler examination. Using pattern recognition, the typical ultrasound appearance was a large solid tumor with inhomogeneous echogenicity of the solid tissue and often dispersed cysts which, in most cases, were small and irregular. Some tumors had smooth contours while others had irregular contours. CONCLUSIONS A unilateral, large solid tumor with inhomogeneous echogenicity of the solid tissue and with dispersed small cystic areas in a young woman should raise the suspicion of a rare malignant germ cell tumor. This suspicion can guide the clinician to test tumor markers specific for malignant germ cell tumors. © 2020 International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- F Moro
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
| | - L M Castellano
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
- Department of Obstetrics and Gynecology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - D Franchi
- Preventive Gynecology Unit, Division of Gynecology, European Institute of Oncology, IRCCS, Milan, Italy
| | - E Epstein
- Department of Clinical Science and Education, Karolinska Institutet and Department of Obstetrics and Gynecology, Sodersjukhuset, Stockholm, Sweden
| | - D Fischerova
- Gynecological Oncology Center, Department of Obstetrics and Gynecology, Charles University, Prague, Czech Republic
| | - W Froyman
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium; Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium
| | - D Timmerman
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium; Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium
| | - G F Zannoni
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
- Dipartimento Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - G Scambia
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
- Dipartimento Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - L Valentin
- Skåne University Hospital Malmö, Malmö, Sweden
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - A C Testa
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
- Dipartimento Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - F Mascilini
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
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Sinagra JL, Vedovelli C, Binazzi R, Salemme A, Moro F, Mazzanti C, Didona B, Di Zenzo G. Case Report: Complete and Fast Recovery From Severe COVID-19 in a Pemphigus Patient Treated With Rituximab. Front Immunol 2021; 12:665522. [PMID: 33936104 PMCID: PMC8087171 DOI: 10.3389/fimmu.2021.665522] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 03/29/2021] [Indexed: 01/08/2023] Open
Abstract
COVID-19 is characterized by a severe pulmonary disease due to severe acute respiratory syndrome (SARS)-CoV-2 infection. For clinicians involved in the management of patients with chronic autoimmune diseases the risk linked to the conditions itself and to drug-induced immunosuppression during the COVID-19 pandemic is a major topic. Pemphigus is a rare autoimmune blistering disease (AIBD) of the skin and mucous membranes caused by autoantibodies to desmosomal components, desmoglein 1 and 3. Among immunosuppressant therapies, rituximab (RTX) is considered a highly effective treatment with a favorable safety profile, but it induces a prolonged B-cell depletion that can lead to higher susceptibility to infections. For this reason, concerns about its use during the pandemic have been raised. We describe a case of a pemphigus patient in which RTX-induced B cell depletion led to the severe inflammatory phase, whereas corticosteroid treatment allowed a favorable outcome.
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Affiliation(s)
| | - Claudio Vedovelli
- Department of Infectious Diseases, Central Hospital of Bolzano, Bolzano, Italy
| | - Raffaella Binazzi
- Department of Infectious Diseases, Central Hospital of Bolzano, Bolzano, Italy
| | - Adele Salemme
- Molecular and Cell Biology Laboratory IDI-IRCCS, Rome, Italy
| | - Francesco Moro
- Molecular and Cell Biology Laboratory IDI-IRCCS, Rome, Italy
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Codecà C, Moruzzi MC, Spina MR, Moro F, Scambia G, Testa AC. Ultrasound features of appendiceal adenoneuroendocrine carcinoma metastatic to ovaries. Ultrasound Obstet Gynecol 2021; 57:503-504. [PMID: 32202677 DOI: 10.1002/uog.22022] [Citation(s) in RCA: 1] [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] [Received: 12/15/2019] [Revised: 03/18/2020] [Accepted: 03/18/2020] [Indexed: 06/10/2023]
Affiliation(s)
- C Codecà
- Dipartimento Scienze della Salute della Donna, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, del Bambino e di Sanità Pubblica, Rome, Italy
| | - M C Moruzzi
- Dipartimento Scienze della Salute della Donna, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, del Bambino e di Sanità Pubblica, Rome, Italy
| | - M R Spina
- Dipartimento Scienze della Salute della Donna, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, del Bambino e di Sanità Pubblica, Rome, Italy
| | - F Moro
- Dipartimento Scienze della Salute della Donna, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, del Bambino e di Sanità Pubblica, Rome, Italy
| | - G Scambia
- Dipartimento Scienze della Salute della Donna, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, del Bambino e di Sanità Pubblica, Rome, Italy
| | - A C Testa
- Dipartimento Scienze della Salute della Donna, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, del Bambino e di Sanità Pubblica, Rome, Italy
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Codecà C, Moruzzi MC, Paris V, Moro F, Scambia G, Testa AC. Ultrasound features of ovarian recurrence of medullary thyroid carcinoma. Ultrasound Obstet Gynecol 2021; 57:347-348. [PMID: 31994806 DOI: 10.1002/uog.21983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 01/15/2020] [Indexed: 06/10/2023]
Affiliation(s)
- C Codecà
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
| | - M C Moruzzi
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
| | - V Paris
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
| | - F Moro
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
| | - G Scambia
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
| | - A C Testa
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
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Fania L, Moro F, De Paolis E, Provini A, Salemme A, Mariotti F, Sinagra JLM, Mazzanti C, Ruzzi L, Capoluongo E, Di Zenzo G. Pemphigus vulgaris in two pairs of siblings from two unrelated Italian families: Human leukocyte antigen genotypes, ST18 mutation and immunological profile. J Dermatol 2020; 48:211-214. [PMID: 33258504 DOI: 10.1111/1346-8138.15656] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 09/18/2020] [Indexed: 11/30/2022]
Abstract
Pemphigus vulgaris (PV) is an autoimmune intraepithelial bullous disease. Associations with the class II human leukocyte antigen (HLA) alleles and pemphigus vulgaris have been described. Furthermore, an association between the single nucleotide polymorphism of the ST18 gene and pemphigus vulgaris has been reported. We report two pairs of siblings from two unrelated Italian families affected by pemphigus vulgaris, characterizing their genetic and immunological profile. In order to assess the genetic background, HLA-DQA1, HLA-DQB1, HLA-DRB1 and a relevant ST18 polymorphism were investigated. As for the immunological profiles, anti-desmoglein antibodies were analyzed. In family A, the two pemphigus vulgaris patients had the same HLA genetic profile: HLA-DQA1 *01:04/*03:01, HLA-DQB1 *03:02/*05:03 and HLA-DRB1 *04:02/*14:01. The male patient was heterozygous for the ST18 mutation while the female patient had a wild genotype. In family B, the two pemphigus vulgaris patients were both wild type for the ST18 mutation and showed the same HLA genotype: HLA-DQA1 *03:01/*05:08, HLA-DQB1 *03:01/*03:03 and HLA-DRB1 *04:02/*11:01. Our data show a relevant relationship between the HLA profile and pemphigus vulgaris in our Italian families. In family A, all six alleles are frequently associated with pemphigus vulgaris and were expressed only in the two pemphigus patients; and in family B, two of the six alleles are frequently associated with pemphigus vulgaris. No relevant relationship was found between ST18 polymorphism and pemphigus disease.
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Affiliation(s)
- Luca Fania
- First Dermatology Division, IDI-IRCCS, Rome, Italy
| | | | - Elisa De Paolis
- Molecular Diagnostics and Genomics Laboratory, Fondazione Policlinico Universitario A. Gemelli IRCCS, Italy
| | | | | | | | | | | | - Laura Ruzzi
- Clinical Analysis Laboratory, IDI-IRCCS, Rome, Italy
| | - Ettore Capoluongo
- Advanced Biotechnology, Department of Molecular Medicine and Medical Biotechnology, Federico II University - CEINGE, Naples, Italy
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Moro F, Bolomini G, Sibal M, Vijayaraghavan SB, Venkatesh P, Nardelli F, Pasciuto T, Mascilini F, Pozzati F, Leone FPG, Josefsson H, Epstein E, Guerriero S, Scambia G, Valentin L, Testa AC. Imaging in gynecological disease (20): clinical and ultrasound characteristics of adnexal torsion. Ultrasound Obstet Gynecol 2020; 56:934-943. [PMID: 31975482 DOI: 10.1002/uog.21981] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Revised: 12/31/2019] [Accepted: 01/14/2020] [Indexed: 06/10/2023]
Abstract
OBJECTIVES To describe the clinical and ultrasound characteristics of adnexal torsion. METHODS This was a retrospective study. From the operative records of the eight participating gynecological ultrasound centers, we identified patients with a surgically confirmed diagnosis of adnexal torsion, defined as surgical evidence of ovarian pedicle, paraovarian cyst and/or Fallopian tube twisted on its own axis, who had undergone preoperative ultrasound examination by an experienced examiner, between 2008 and 2018. Only cases with at least two available ultrasound images and/or videoclips (one grayscale and one with Doppler evaluation) were included. Clinical, ultrasound, surgical and histological information was retrieved from each patient's medical record and entered into an Excel file by the principal investigator at each center. In addition, two authors reviewed all available ultrasound images and videoclips of the twisted adnexa, with regard to the presence of four predefined ultrasound features reported to be characteristic of adnexal torsion: (1) ovarian stromal edema with or without peripherally displaced antral follicles, (2) the follicular ring sign, (3) the whirlpool sign and (4) absence of vascularization in the twisted organ. RESULTS A total of 315 cases of adnexal torsion were identified. The median age of the patients was 30 (range, 1-88) years. Most patients were premenopausal (284/314; 90.4%) and presented with acute or subacute pelvic pain (305/315; 96.8%). The surgical approach was laparoscopic in 239/312 (76.6%) patients and conservative surgery (untwisting with or without excision of a lesion) was performed in 149/315 (47.3%) cases. According to the original ultrasound reports, the median largest diameter of the twisted organ was 83 (range, 30-349) mm. Free fluid in the pouch of Douglas was detected in 196/275 (71.3%) patients. Ovarian stromal edema with or without peripherally displaced antral follicles was reported in the original ultrasound report in 167/241 (69.3%) patients, the whirlpool sign in 178/226 (78.8%) patients, absent color Doppler signals in the twisted organ in 119/269 (44.2%) patients and the follicular ring sign in 51/134 (38.1%) patients. On retrospective review of images and videoclips, ovarian stromal edema with or without peripherally displaced antral follicles (201/254; 79.1%) and the whirlpool sign (139/153; 90.8%) were the most commonly detected features of adnexal torsion. CONCLUSION Most patients with surgically confirmed adnexal torsion are of reproductive age and present with acute or subacute pain. Common ultrasound signs are an enlarged adnexa, the whirlpool sign, ovarian stromal edema with or without peripherally displaced antral follicles and free fluid in the pelvis. The follicular ring sign and absence of Doppler signals in the twisted organ are slightly less common signs. Recognizing ultrasound signs of adnexal torsion is important so that the correct treatment, i.e. surgery without delay, can be offered. Copyright © 2020 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- F Moro
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
| | - G Bolomini
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
| | - M Sibal
- Department of Fetal Medicine and Obstetric and Gynecologic Ultrasound, Manipal Hospital, Bangalore, India
| | | | - P Venkatesh
- Department of Fetal Medicine and OBGYN Ultrasound, Manipal Hospital, Bangalore, India
| | - F Nardelli
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
- Institute for Women's Health, University College Hospital, London, UK
| | - T Pasciuto
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
| | - F Mascilini
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
| | - F Pozzati
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
- Istituto di Clinica Ostetrica e Ginecologica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - F P G Leone
- Department of Obstetrics and Gynecology, Biomedical and Clinical Sciences Institute L. Sacco, University of Milan, Milan, Italy
| | - H Josefsson
- Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden
- Department of Obstetrics and Gynecology, Södersjukhuset, Stockholm, Sweden
| | - E Epstein
- Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden
- Department of Obstetrics and Gynecology, Södersjukhuset, Stockholm, Sweden
| | - S Guerriero
- Department of Obstetrics and Gynecology, University of Cagliari, Policlinico Universitario Duilio Casula, Monserrato, Cagliari, Italy
| | - G Scambia
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
- Istituto di Clinica Ostetrica e Ginecologica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - L Valentin
- Department of Obstetrics and Gynecology, Skåne University Hospital, Malmö, Sweden
- Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - A C Testa
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
- Istituto di Clinica Ostetrica e Ginecologica, Università Cattolica del Sacro Cuore, Rome, Italy
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Moro F, Colangeli A, Del Nevo A, Flammini D, Mariano G, Martelli E, Mozzillo R, Noce S, Villari R. Nuclear analysis of the Water cooled lithium lead DEMO reactor. Fusion Engineering and Design 2020. [DOI: 10.1016/j.fusengdes.2020.111833] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Ambrosio M, Testa AC, Moro F, Franchi D, Scifo MC, Rams N, Epstein E, Alcazar JL, Hidalgo JJ, Van Holsbeke C, Burgetova A, Dundr P, Cibula D, Fischerova D. Imaging in gynecological disease (19): clinical and ultrasound features of extragastrointestinal stromal tumors (eGIST). Ultrasound Obstet Gynecol 2020; 56:749-758. [PMID: 31909545 DOI: 10.1002/uog.21968] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 12/18/2019] [Accepted: 12/20/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To describe the clinical and sonographic characteristics of extragastrointestinal stromal tumors (eGISTs). METHODS This was a retrospective multicenter study. The data of patients with a histological diagnosis of eGIST who had undergone preoperative ultrasound examination were retrieved from the databases of nine large European gynecologic oncology centers. One investigator from each center reviewed stored images and ultrasound reports, and described the lesions using the terminology of the International Ovarian Tumor Analysis and Morphological Uterus Sonographic Assessment groups, following a predefined ultrasound evaluation form. Clinical, surgical and pathological information was also recorded. RESULTS Thirty-five women with an eGIST were identified; in 17 cases, the findings were incidental, and 18 cases were symptomatic. Median age was 57 years (range, 21-85 years). Tumor marker CA 125 was available in 23 (65.7%) patients, with a median level of 23 U/mL (range, 7-403 U/mL). The vast majority of eGISTs were intraperitoneal lesions (n = 32 (91.4%)); the remaining lesions were retroperitoneal (n = 2 (5.7%)) or preperitoneal (n = 1 (2.9%)). The most common site of the tumor was the abdomen (n = 23 (65.7%)), and less frequently the pelvis (n = 12 (34.3%)). eGISTs were typically large (median largest diameter, 79 mm) solid (n = 31 (88.6%)) tumors, and were less frequently multilocular-solid tumors (n = 4 (11.4%)). The echogenicity of solid tumors was uniform in 8/31 (25.8%) cases, which were all hypoechogenic. Twenty-three solid eGISTs were non-uniform, either with mixed echogenicity (9/23 (39.1%)) or with cystic areas (14/23 (60.9%)). The tumor shape was mainly lobular (n = 19 (54.3%)) or irregular (n = 10 (28.6%)). Tumors were typically richly vascularized (color score of 3 or 4, n = 31 (88.6%)) with no shadowing (n = 31 (88.6%)). Based on pattern recognition, eGISTs were usually correctly classified as a malignant lesion in the ultrasound reports (n = 32 (91.4%)), and the specific diagnosis of eGIST was the most frequent differential diagnosis (n = 16 (45.7%)), followed by primary ovarian cancer (n = 5 (14.3%)), lymphoma (n = 2 (5.7%)) and pedunculated uterine fibroid (n = 2 (5.7%)). CONCLUSIONS On ultrasound, eGISTs were usually solid, non-uniform pelvic or abdominal lobular tumors of mixed echogenicity, with or without cystic areas, with rich vascularization and no shadowing. The presence of a tumor with these features, without connection to the bowel wall, and not originating from the uterus or adnexa, is highly suspicious for eGIST. Copyright © 2020 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- M Ambrosio
- Department of Obstetrics and Gynecology, S. Orsola Malpighi Hospital, University of Bologna, Bologna, Italy
| | - A C Testa
- Dipartimento Scienze della Salute della Donna e del Bambino, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
- Dipartimento Scienze della Vita e Sanità pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - F Moro
- Dipartimento Scienze della Salute della Donna e del Bambino, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - D Franchi
- Division of Gynecology, European Institute of Oncology, Milan, Italy
| | - M C Scifo
- Department of Obstetrics and Gynecology, S. Orsola Malpighi Hospital, University of Bologna, Bologna, Italy
| | - N Rams
- Hospital Santa Cruz y San Pablo, Barcelona, Spain
| | - E Epstein
- Department of Clinical Science and Education, Karolinska Institutet & Department of Obstetrics and Gynecology, Södersjukhuset, Stockholm, Sweden
| | - J L Alcazar
- Department of Obstetrics and Gynecology, Clinica Universidad de Navarra, University of Navarra, Pamplona, Spain
| | - J J Hidalgo
- Department of Obstetrics and Gynecology, Clinic Hospital Valencia, Valencia, Spain
| | | | - A Burgetova
- Department of Radiology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - P Dundr
- Department of Pathology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - D Cibula
- Department of Obstetrics and Gynecology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - D Fischerova
- Department of Obstetrics and Gynecology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
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De Blasis I, Moro F, Di Carlo V, Scambia G, Exacoustos C, Testa AC. Longitudinal ultrasound evaluation of clear-cell ovarian carcinoma. Ultrasound Obstet Gynecol 2020; 56:784-785. [PMID: 31908070 DOI: 10.1002/uog.21961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 12/23/2019] [Indexed: 06/10/2023]
Affiliation(s)
- I De Blasis
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
| | - F Moro
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
| | - V Di Carlo
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
| | - G Scambia
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
- Università Cattolica del Sacro Cuore, Istituto di Ginecologia e Ostetricia, Rome, Italy
| | - C Exacoustos
- Department of Biomedicine and Prevention, Obstetrics and Gynecological Clinic, University of Rome Tor Vergata, Rome, Italy
| | - A C Testa
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
- Università Cattolica del Sacro Cuore, Istituto di Ginecologia e Ostetricia, Rome, Italy
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Abstract
An experimental procedure is assessed to obtain moderated neutron fields starting from almost monochromatic 14 MeV neutrons generated by means of an accelerator-driven D-T source. The use of a metallic pre-moderator and a standard hydrogen-containing moderator is effective in producing neutron spectra featuring a thermal peak and an epithermal slowing down tail extending up to 14 MeV. The performance of proposed moderation system was investigated by means of MCNP Monte Carlo calculations, benchmarked against experimental measurements using an explorative set up, assembled at the Frascati Neutron Generator. The benchmarked calculations allow at making predictions about the brilliance of a 14 MeV neutron moderator in view of possible applications in neutron science.
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Affiliation(s)
- D. Flammini
- ENEA Dept. Fusion and Technologies for Nuclear Safety and Security, Frascati, Roma, Italy. E-mails: , ,
| | - R. Bedogni
- Istituto Nazionale di Fisica Nucleare, Laboratori Nazionali di Frascati, Frascati, Roma, Italy. E-mail:
| | - F. Moro
- ENEA Dept. Fusion and Technologies for Nuclear Safety and Security, Frascati, Roma, Italy. E-mails: , ,
| | - A. Pietropaolo
- ENEA Dept. Fusion and Technologies for Nuclear Safety and Security, Frascati, Roma, Italy. E-mails: , ,
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Moro F, Fania L, Sinagra JLM, Salemme A, Di Zenzo G. Bullous Pemphigoid: Trigger and Predisposing Factors. Biomolecules 2020; 10:E1432. [PMID: 33050407 PMCID: PMC7600534 DOI: 10.3390/biom10101432] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 10/01/2020] [Accepted: 10/08/2020] [Indexed: 12/14/2022] Open
Abstract
Bullous pemphigoid (BP) is the most frequent autoimmune subepidermal blistering disease provoked by autoantibodies directed against two hemidesmosomal proteins: BP180 and BP230. Its pathogenesis depends on the interaction between predisposing factors, such as human leukocyte antigen (HLA) genes, comorbidities, aging, and trigger factors. Several trigger factors, such as drugs, thermal or electrical burns, surgical procedures, trauma, ultraviolet irradiation, radiotherapy, chemical preparations, transplants, and infections may induce or exacerbate BP disease. Identification of predisposing and trigger factors can increase the understanding of BP pathogenesis. Furthermore, an accurate anamnesis focused on the recognition of a possible trigger factor can improve prognosis by promptly removing it.
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Affiliation(s)
- Francesco Moro
- Correspondence: (F.M.); (L.F.); Tel.: +39-(342)-802-0004 (F.M.)
| | - Luca Fania
- Correspondence: (F.M.); (L.F.); Tel.: +39-(342)-802-0004 (F.M.)
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Andreoli F, Angelone M, Colangeli A, Besi Vetrella U, Fiore S, Flammini D, Del Prete P, Loreti S, Mariano G, Mazzitelli G, Moro F, Pagano G, Pietropaolo A, Pillon M, Terranova N, Villari R, Naish J, Nobs C, Packer L. Comparison between measurement and calculations for a 14 MeV neutron water activation experiment. EPJ Web Conf 2020. [DOI: 10.1051/epjconf/202023921002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The nuclear heat loads due to gamma rays emitted from the decay of 16N and delayed neutrons from17N, generated by the activation of water in cooling circuits, are critical for ITER design. The assessment of nuclear heating from activated water is complex; it requires temporal and spatial dependent transport and activation calculations taking into account variation of irradiation, water flow conditions and cooling circuits’ parameters. A water activation experiment has been recently conducted at the14 MeV Frascati Neutron Generator (FNG) in order to validate the methodology for water activation assessment used for ITER and to reduce the safety factors applied to the calculation results, which have a large impact on the schedule, commissioning and licensing. Water circulating inside an ITER First Wall (FW) mock-up was irradiated with 14 MeV neutrons and then measured using a large CsI scintillator detector. The system consists of a closed water loop where the cooling water, transiting through an ITER FW mock-up, is irradiated by FNG. The induced 16N activity via 14 MeV neutrons interactions with 16O via the 16O(n,p)16N reaction is measured in a dedicated counting station via an expansion volume. The water then passes to a much larger holding delay tank, and after several 16N half-lives decay time, it is then recirculated and exposed again to neutrons in the ITER First Wall (FW) mock-up. The measured 16N activity is obtained measuring the emitted characteristic 6.13 and 7.12 MeV gamma-rays. Calculations were performed in an accurate model of the FW mock-up using the MCNP Monte Carlo code and FENDL-3.1 nuclear data library to obtain the predicted flux impinging on the water. The EASY-2007 inventory code was used to predict the 16N activity. In this work, a comparison between measurements and calculations is reported together with associated uncertainty analysis.
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Buonsenso D, Inchingolo R, Smargiassi A, Demi L, Scambia G, Testa AC, Moro F. Reply. Ultrasound Obstet Gynecol 2020; 56:468-469. [PMID: 32870589 DOI: 10.1002/uog.22157] [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] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- D Buonsenso
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
| | - R Inchingolo
- Dipartimento Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
| | - A Smargiassi
- Dipartimento Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
| | - L Demi
- Department of Information Engineering and Computer Science, University of Trento, Trento, Italy
| | - G Scambia
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
- Dipartimento Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - A C Testa
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
- Dipartimento Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - F Moro
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
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Buonsenso D, Inchingolo R, Smargiassi A, Demi L, Scambia G, Testa AC, Moro F. Reply. Ultrasound Obstet Gynecol 2020; 56:470-471. [PMID: 32870587 DOI: 10.1002/uog.22147] [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] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- D Buonsenso
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
| | - R Inchingolo
- Dipartimento Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
| | - A Smargiassi
- Dipartimento Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
| | - L Demi
- Department of Information Engineering and Computer Science, University of Trento, Trento, Italy
| | - G Scambia
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
- Dipartimento Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - A C Testa
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
- Dipartimento Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - F Moro
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
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Flammini D, Angelone M, Caiffi B, Colangeli A, Fonnesu N, Mariano G, Moro F, Villari R. Pre-analysis of the WCLL breeding blanket mock-up neutronics experiment at the frascati neutron generator. Fusion Engineering and Design 2020. [DOI: 10.1016/j.fusengdes.2020.111600] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Buonsenso D, Raffaelli F, Tamburrini E, Biasucci DG, Salvi S, Smargiassi A, Inchingolo R, Scambia G, Lanzone A, Testa AC, Moro F. Clinical role of lung ultrasound for diagnosis and monitoring of COVID-19 pneumonia in pregnant women. Ultrasound Obstet Gynecol 2020; 56:106-109. [PMID: 32337795 PMCID: PMC7267364 DOI: 10.1002/uog.22055] [Citation(s) in RCA: 78] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 04/12/2020] [Accepted: 04/15/2020] [Indexed: 05/03/2023]
Abstract
Lung ultrasound has been suggested recently by the Chinese Critical Care Ultrasound Study Group and Italian Academy of Thoracic Ultrasound as an accurate tool to detect lung involvement in COVID-19. Although chest computed tomography (CT) represents the gold standard to assess lung involvement, with a specificity superior even to that of the nasopharyngeal swab for diagnosis, lung ultrasound examination can be a valid alternative to CT scan, with certain advantages, particularly for pregnant women. Ultrasound can be performed directly at the bed-side by a single operator, reducing the risk of spreading the disease among health professionals. Furthermore, it is a radiation-free exam, making it safer and easier to monitor those patients who require a series of exams. We report on four cases of pregnant women affected by COVID-19 who were monitored with lung ultrasound examination. All patients showed sonographic features indicative of COVID-19 pneumonia at admission: irregular pleural lines and vertical artifacts (B-lines) were observed in all four cases, and patchy areas of white lung were observed in two. Lung ultrasound was more sensitive than was chest X-ray in detecting COVID-19. In three patients, we observed almost complete resolution of lung pathology on ultrasound within 96 h of admission. Two pregnancies were ongoing at the time of writing, and two had undergone Cesarean delivery with no fetal complications. Reverse transcription polymerase chain reaction analysis of cord blood and newborn swabs was negative in both of these cases. Copyright © 2020 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- D. Buonsenso
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità PubblicaFondazione Policlinico Universitario A. Gemelli, IRCCSRomeItaly
- Dipartimento Scienze della Vita e Sanità PubblicaUniversità Cattolica del Sacro CuoreRomeItaly
| | - F. Raffaelli
- Dipartimento Scienze di Laboratorio e InfettivologicheFondazione Policlinico Universitario A. Gemelli, IRCCSRomeItaly
- Istituto di Clinica di Malattie InfettiveUniversità del Sacro CuoreRomeItaly
| | - E. Tamburrini
- Dipartimento Scienze di Laboratorio e InfettivologicheFondazione Policlinico Universitario A. Gemelli, IRCCSRomeItaly
- Istituto di Clinica di Malattie InfettiveUniversità del Sacro CuoreRomeItaly
| | - D. G. Biasucci
- Intensive Care Unit, Department of Emergency, Anesthesiology and Intensive Care MedicineFondazione Policlinico Universitario A. Gemelli IRCCSRomeItaly
| | - S. Salvi
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità PubblicaFondazione Policlinico Universitario A. Gemelli, IRCCSRomeItaly
| | - A. Smargiassi
- Dipartimento Scienze Mediche e ChirurgicheFondazione Policlinico Universitario A. Gemelli, IRCCSRomeItaly
| | - R. Inchingolo
- Dipartimento Scienze Mediche e ChirurgicheFondazione Policlinico Universitario A. Gemelli, IRCCSRomeItaly
| | - G. Scambia
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità PubblicaFondazione Policlinico Universitario A. Gemelli, IRCCSRomeItaly
- Dipartimento Scienze della Vita e Sanità PubblicaUniversità Cattolica del Sacro CuoreRomeItaly
| | - A. Lanzone
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità PubblicaFondazione Policlinico Universitario A. Gemelli, IRCCSRomeItaly
- Dipartimento Scienze della Vita e Sanità PubblicaUniversità Cattolica del Sacro CuoreRomeItaly
| | - A. C. Testa
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità PubblicaFondazione Policlinico Universitario A. Gemelli, IRCCSRomeItaly
- Dipartimento Scienze della Vita e Sanità PubblicaUniversità Cattolica del Sacro CuoreRomeItaly
| | - F. Moro
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità PubblicaFondazione Policlinico Universitario A. Gemelli, IRCCSRomeItaly
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Buonsenso D, Moro F, Inchingolo R, Smargiassi A, Demi L, Soldati G, Moroni R, Lanzone A, Scambia G, Testa AC. Effectiveness of rapid lung ultrasound training program for gynecologists and obstetricians managing pregnant women with suspected COVID-19. Ultrasound Obstet Gynecol 2020; 56:110-111. [PMID: 32349175 PMCID: PMC7267379 DOI: 10.1002/uog.22066] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 04/18/2020] [Accepted: 04/23/2020] [Indexed: 05/22/2023]
Affiliation(s)
- D. Buonsenso
- Dipartimento Scienze della Salute della Donnadel Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCSRomeItaly
| | - F. Moro
- Dipartimento Scienze della Salute della Donnadel Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCSRomeItaly
| | - R. Inchingolo
- Dipartimento Scienze Mediche e ChirurgicheFondazione Policlinico Universitario Agostino Gemelli, IRCCSRomeItaly
| | - A. Smargiassi
- Dipartimento Scienze Mediche e ChirurgicheFondazione Policlinico Universitario Agostino Gemelli, IRCCSRomeItaly
| | - L. Demi
- Department of Information Engineering and Computer ScienceUniversity of TrentoTrentoItaly
| | - G. Soldati
- Diagnostic and Interventional Ultrasound UnitValle del Serchio General HospitalLuccaItaly
| | - R. Moroni
- Direzione ScientificaFondazione Policlinico Universitario Agostino Gemelli IRCCSRomeItaly
| | - A. Lanzone
- Dipartimento Scienze della Salute della Donnadel Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCSRomeItaly
- Dipartimento Scienze della Vita e Sanità PubblicaUniversità Cattolica del Sacro CuoreRomeItaly
| | - G. Scambia
- Dipartimento Scienze della Salute della Donnadel Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCSRomeItaly
- Dipartimento Scienze della Vita e Sanità PubblicaUniversità Cattolica del Sacro CuoreRomeItaly
| | - A. C. Testa
- Dipartimento Scienze della Salute della Donnadel Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCSRomeItaly
- Dipartimento Scienze della Vita e Sanità PubblicaUniversità Cattolica del Sacro CuoreRomeItaly
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Moro F, Buonsenso D, Testa AC. Reply. Ultrasound Obstet Gynecol 2020; 56:124. [PMID: 32608571 DOI: 10.1002/uog.22092] [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] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- F Moro
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
| | - D Buonsenso
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
| | - A C Testa
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
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48
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Puttisong Y, Moro F, Chen SL, Höjer P, Ning W, Gao F, Buyanova IA, Chen WM. Effect of Crystal Symmetry on the Spin States of Fe 3+ and Vibration Modes in Lead-free Double-Perovskite Cs 2AgBi(Fe)Br 6. J Phys Chem Lett 2020; 11:4873-4878. [PMID: 32486640 DOI: 10.1021/acs.jpclett.0c01543] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
We show by electron spin resonance (ESR) and Raman spectroscopies that the crystal phase transition of the lead-free double-perovskite Cs2AgBiBr6 has a profound symmetry-breaking effect on the high spin states of, for example, a transition-metal ion Fe3+ and the vibrational modes. It lifts their degeneracy when the crystal undergoes the cubic-tetragonal phase transition, splitting the six-fold degenerate S = 5/2 state of Fe3+ to three Kramer doublets and the enharmonic breathing mode Tg of the MBr6 octahedra (M = Ag, Bi, Fe) into Eg + Ag. The magnitudes of both spin and Raman line splitting are shown to directly correlate with the strength of the tetragonal strain field. This work, in turn, demonstrates the power of the ESR and Raman spectroscopies in probing structural phase transitions and in providing in-depth information on the interplay between the structural, spin, and vibrational properties of lead-free double perovskites, a newly emerging and promising class of materials for low-cost and high-efficiency photovoltaics and optoelectronics.
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Affiliation(s)
- Y Puttisong
- Department of Physics, Chemistry, and Biology (IFM), Linköping University, SE-58183 Linköping, Sweden
| | - F Moro
- Department of Physics, Chemistry, and Biology (IFM), Linköping University, SE-58183 Linköping, Sweden
| | - S L Chen
- Department of Physics, Chemistry, and Biology (IFM), Linköping University, SE-58183 Linköping, Sweden
| | - P Höjer
- Department of Physics, Chemistry, and Biology (IFM), Linköping University, SE-58183 Linköping, Sweden
| | - W Ning
- Department of Physics, Chemistry, and Biology (IFM), Linköping University, SE-58183 Linköping, Sweden
| | - F Gao
- Department of Physics, Chemistry, and Biology (IFM), Linköping University, SE-58183 Linköping, Sweden
| | - I A Buyanova
- Department of Physics, Chemistry, and Biology (IFM), Linköping University, SE-58183 Linköping, Sweden
| | - W M Chen
- Department of Physics, Chemistry, and Biology (IFM), Linköping University, SE-58183 Linköping, Sweden
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Moruzzi MC, Moro F, Bolomini G, Macchi C, Cavaliere AF, Fagotti A, Scambia G, Testa AC. Intraoperative ultrasound assistance during myomectomy in pregnant woman. Ultrasound Obstet Gynecol 2020; 55:840-841. [PMID: 31587408 DOI: 10.1002/uog.21881] [Citation(s) in RCA: 1] [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] [Received: 05/25/2019] [Revised: 09/18/2019] [Accepted: 09/19/2019] [Indexed: 06/10/2023]
Affiliation(s)
- M C Moruzzi
- Dipartimento Scienze della Salute della Donna, del Bambino, e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - F Moro
- Dipartimento Scienze della Salute della Donna, del Bambino, e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - G Bolomini
- Dipartimento Scienze della Salute della Donna, del Bambino, e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - C Macchi
- Dipartimento Scienze della Salute della Donna, del Bambino, e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - A F Cavaliere
- Dipartimento Scienze della Salute della Donna, del Bambino, e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Istituto di Ginecologia e Ostetricia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - A Fagotti
- Dipartimento Scienze della Salute della Donna, del Bambino, e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Istituto di Ginecologia e Ostetricia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - G Scambia
- Dipartimento Scienze della Salute della Donna, del Bambino, e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Istituto di Ginecologia e Ostetricia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - A C Testa
- Dipartimento Scienze della Salute della Donna, del Bambino, e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Istituto di Ginecologia e Ostetricia, Università Cattolica del Sacro Cuore, Rome, Italy
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Moro F, Buonsenso D, Moruzzi MC, Inchingolo R, Smargiassi A, Demi L, Larici AR, Scambia G, Lanzone A, Testa AC. How to perform lung ultrasound in pregnant women with suspected COVID-19. Ultrasound Obstet Gynecol 2020; 55:593-598. [PMID: 32207208 DOI: 10.1002/uog.22028] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 03/19/2020] [Accepted: 03/20/2020] [Indexed: 05/02/2023]
Abstract
Under certain circumstances, such as during the current COVID-19 outbreak, pregnant women can be a target for respiratory infection, and lung examination may be required as part of their clinical evaluation, ideally while avoiding exposure to radiation. We propose a practical approach for obstetricians/gynecologists to perform lung ultrasound examination, discussing potential applications, semiology and practical aspects, which could be of particular importance in emergency situations, such as the current pandemic infection of COVID-19. Copyright © 2020 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- F Moro
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
| | - D Buonsenso
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
| | - M C Moruzzi
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
| | - R Inchingolo
- Dipartimento Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
| | - A Smargiassi
- Dipartimento Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
| | - L Demi
- Department of Information Engineering and Computer Science, University of Trento, Trento, Italy
| | - A R Larici
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica e Ematologia, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
- Dipartimento Universitario di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy
| | - G Scambia
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
- Dipartimento Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - A Lanzone
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
- Dipartimento Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - A C Testa
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
- Dipartimento Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
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